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WEN <br />U <br />i <br />' L J <br />C <br />3 r <br />1 <br />•.f •. �a •�I���.. It u• � l.�t �� .L• t +': T'li! \ , ��It )t� }y 1 •l - _ 1. t. `Y•`. - .f �1 + - +r -.. <br />AFFIDAVIT <br />f. <br />STATE OF NEBRASKA) 90--- 105269 <br />)ss. <br />COUNTY OF HALM. ) <br />The undersigned Affiant, being first duly sworn upon oath, <br />deposes and states as follows: <br />1. That the Affiant is then survive ng spouse of Ellery C. <br />Lenz, who depar."d this life on Au,& _Mot, 24, 1990, as shown by <br />the certified copy of the death iporcttificate attached hereto <br />, ''•`. <br />as Exhibit . PA" and by this reference' i nebrporatod herein. <br />2. That on the date of death, the Affiant and Decedent <br />were the r1ole ow' nerd as joint tionants with rights of survivorshhip <br />of real est4te legally described as follows: <br />1+<,t four (4), iT;ara Leigh Subdivision, in the <br />Cltcy of Grand Island, Hall County, Nebraska. <br />h <br />3. That by virtue of the survivorship of the Affiant, <br />2 <br />Affiant became the sole owner of the above described property. <br />4. This Affidavit is given as evidence that pursuant to <br />�'• 77-2003, no inheritance tax lion arising <br />due <br />to the death of the De�.edent can attach to the above described <br />real estate and that no Nebraska Estate Tax Lien arising due to <br />the death of the Decedent can attach to the above described real <br />- <br />estate. <br />S. That the gross estate of the Decedent was leas than that <br />amount exempt from federal estate taxes. <br />Further Affiant sayeth not. <br />DATED this .11 day of ClL , 1 990. <br />DONNA J. LE14 , A-Of iant V ' <br />1 <br />Subscribed and sworn to before me this , d of , <br />1990. <br />Mat <br />otary nu is <br />U <br />i <br />' L J <br />C <br />3 r <br />1 <br />•.f •. �a •�I���.. It u• � l.�t �� .L• t +': T'li! \ , ��It )t� }y 1 •l - _ 1. t. `Y•`. - .f �1 + - +r -.. <br />