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N <br />MINIMENE <br />N® <br />0) <br />1. <br />M1 <br />3 <br />V A B ( I' 2 I <br />i <br />Date of Death: <br />G1 <br />3 <br />STATE OF NEBRASKA ) <br />) ss. <br />COUNTY OF HALL ) <br />Name of Decedent: <br />Domicile at Date of Death: <br />Name of Surviving Spouse: <br />GENERAL NOTARY - State of Nebraska <br />GALEN E. STEHLIK <br />My Comm. Exp. May 1, 2018 <br />i <br />Rebecca S. Quandt <br />December 9, 2017 <br />AFFIDAVIT OF MARITAL STATUS <br />Hall County, Nebraska <br />Arthur L. Quandt <br />-3 <br />I—J <br />Crl <br />Arthur L. Quandt <br />SUBSCRIBED and SWORN to before me this 29 day of December, 2017. <br />COMES NOW, the undersigned, being duly sworn, deposes and says that the undersigned is the <br />surviving spouse of the Decedent and that the following information is true and correct: <br />Date of Marriage: August 30, 1969 <br />2. The Affiant is related to the Decedent as follows: Surviving Spouse. <br />3. There is no Federal Estate Tax, Nebraska Inheritance Tax or Nebraska Estate Tax that is due because <br />of Decedent's death. <br />4. Title to the following described real estate is held by the Decedent and the surviving spouse of the <br />Decedent in joint tenancy, to -wit: <br />The Southwest Quarter (SW1 /4) of Section One (1), Township Twelve (12), Range Nine <br />(9), West of the 6t P.M., Hall County, Nebraska. <br />5. As of the date of death, the real estate has a fair market value of $825,492.08. <br />6. The Decedent and Affiant were married as of date of death. There is no Nebraska Inheritance <br />Tax lien by reason of Nebraska Revised Statutes Section 77 -2003. There is no Nebraska estate tax lien by <br />reason of Nebraska Revised Statutes Section 77 -2102. <br />FURTHER AFFIANT SAITH NOT. <br />