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STATE OF NEBRASKA ) <br />) ss: <br />COUNTY OF BUFFALO ) <br />x• <br />rn <br />2 <br />P1 Z <br />n w • <br />7C 2 <br />n n <br />n <br />;73 <br />Cr) <br />Once recorded, please return to: <br />Va Parker, Grossart, Bahensky, Beucke, Bowman & Symington, L.L.P. <br />PO Box 1600, Kearney, NE 68848 -1600 <br />AFFIDAVIT OF <br />SURVIVING SPOUSE <br />Affiant, Mary A. Harders, after being duly sworn upon oath, does depose and state <br />as follows: <br />1. That affiant is the surviving spouse of Ronald L. Harders (hereinafter referred to <br />as the "decedent "), who departed this life on May 28, 2018, as shown by the copy of the <br />death certificate attached hereto as Exhibit "A" and by this reference incorporated herein. <br />2. That on the date of death, the affiant and the decedent were the sole owners as <br />joint tenants with rights of survivorship of that real property described as follows: <br />Lot 2, Thelen Third Subdivision, an Addition to the City of Wood River, <br />Hall County, Nebraska. <br />3. That by virtue of the survivorship of affiant, affiant became the sole owner of the <br />above - described property. <br />4. That this affidavit is given as evidence that pursuant to Neb. Rev. Stat. §77 -2003 <br />(Reissue 2009) no inheritance tax lien arising due to the death of the decedent can attach to <br />the above - described real estate. <br />5. That no federal estate tax return has or will be filed as the gross estate of the <br />decedent was less than that amount necessary to require the filing of such a return pursuant <br />to Internal Revenue Code §6018. <br />Dated: June 13 , 2018. <br />SUBSCRIBED AND SWORN to before me on June 13 , 2018. <br />GENERAL NOTARY - State of Nebraska <br />DAMON T. BAHENSKY <br />My Comm. Exp. August 30, 2021 <br />Mary A. Harders <br />Notary Public <br />r i< 1 ofe- <br />1 <br />ca <br />