|
�O
<br />ra
<br />Nr�
<br />Z D
<br />M cn
<br />n M
<br />STATE OF NEBRASKA
<br />ss .
<br />COUNTY OF HALL
<br />Affiant, FLORENCE I. GOETSCH, after being first duly sworn on /� S
<br />oath, deposes and states as follows:
<br />1. That Affiant is the surviving spouse of ROBERT E. GOETSCH,
<br />who died December 28, 2000, as shown by the certified copy of the
<br />Decedent 's °death certificate attached hereto as Exhibit "A" and by
<br />this reference incorporated herein; that Exhibit "A" is a certified
<br />copy of the original Certificate of Death on file with the Bureau
<br />of Vital Statistics, Department of Health, State of Nebraska.
<br />2. That Affiant and the said Decedent were husband and wife
<br />on the date of the Decedent's death on December 28, 2000, and were
<br />on said date the sole owners as joint tenants not tenants in
<br />common, of the real estate legally described as follows:
<br />Lot Eight (8), Block Seventy -Five (75), Wheeler &
<br />Bennett's 3rd Addition to the City of Grand Island, Hall
<br />County, Nebraska.
<br />3. That by reason of the provisions of the Joint Tenancy
<br />Warranty Deed, Affiant became the sole owner of the above described
<br />property on Decedent's death.
<br />4. That this Affidavit is given as evidence that pursuant to
<br />Neb.Rev.Stat. section 77 -2003, no inheritance tax lien arising due
<br />to the death of the Decedent can attach to the above described real
<br />estate and that pursuant to Neb.Rev.Stat. section 77 -2012, no
<br />Nebraska estate tax lien arising due to the death of the Decedent
<br />can attach to the above described property.
<br />FURTHER AFFIANT SAYETH NOT.
<br />Dated July 25, 2001.
<br />FLORENCE I. GOETSCH
<br />SUBSCRIBED in my presence and sworn to before me by FLORENCE
<br />I. GOETSCH, this 25th day of .7 -1- ')nn,
<br />IIf GENERAL NOTARY State of Nebraska
<br />B.J. CUNNINGHAM, JR.
<br />MY Comm. Exp. 9.17, 2001
<br />i I n n
<br />rn
<br />n
<br />U)
<br /><<
<br />I
<br />c,�
<br />a
<br />o
<br />C_
<br />m
<br />ze =T
<br />Q
<br />N
<br />s
<br />p
<br />�
<br />cy► '+7
<br />O
<br />G
<br />2
<br />N
<br />O
<br />,co
<br />CD
<br />w
<br />Cil
<br />_.
<br />-_
<br />CID
<br />AFFIDAVIT
<br />Affiant, FLORENCE I. GOETSCH, after being first duly sworn on /� S
<br />oath, deposes and states as follows:
<br />1. That Affiant is the surviving spouse of ROBERT E. GOETSCH,
<br />who died December 28, 2000, as shown by the certified copy of the
<br />Decedent 's °death certificate attached hereto as Exhibit "A" and by
<br />this reference incorporated herein; that Exhibit "A" is a certified
<br />copy of the original Certificate of Death on file with the Bureau
<br />of Vital Statistics, Department of Health, State of Nebraska.
<br />2. That Affiant and the said Decedent were husband and wife
<br />on the date of the Decedent's death on December 28, 2000, and were
<br />on said date the sole owners as joint tenants not tenants in
<br />common, of the real estate legally described as follows:
<br />Lot Eight (8), Block Seventy -Five (75), Wheeler &
<br />Bennett's 3rd Addition to the City of Grand Island, Hall
<br />County, Nebraska.
<br />3. That by reason of the provisions of the Joint Tenancy
<br />Warranty Deed, Affiant became the sole owner of the above described
<br />property on Decedent's death.
<br />4. That this Affidavit is given as evidence that pursuant to
<br />Neb.Rev.Stat. section 77 -2003, no inheritance tax lien arising due
<br />to the death of the Decedent can attach to the above described real
<br />estate and that pursuant to Neb.Rev.Stat. section 77 -2012, no
<br />Nebraska estate tax lien arising due to the death of the Decedent
<br />can attach to the above described property.
<br />FURTHER AFFIANT SAYETH NOT.
<br />Dated July 25, 2001.
<br />FLORENCE I. GOETSCH
<br />SUBSCRIBED in my presence and sworn to before me by FLORENCE
<br />I. GOETSCH, this 25th day of .7 -1- ')nn,
<br />IIf GENERAL NOTARY State of Nebraska
<br />B.J. CUNNINGHAM, JR.
<br />MY Comm. Exp. 9.17, 2001
<br />
|