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MilMORAMIN <br />Cymmimimm <br />r <br />~rr� <br />rpt <br />Cr) <br />N <br />r <br />N <br />Return to: Denise D. Myers <br />/ P.O. Box 505 <br />Cairo, NE 68824 <br />AFFIDAVIT FOR TRANSFER <br />OF REAL PROPERTY WITHOUT PROBATE <br />UNDER NEBRASKA PROBATE CODE <br />Section 30-24,129 <br />STATE OF NEBRASKA ) <br />) ss. <br />COUNTY OF HALL ) <br />The undersigned Affiant, upon being first duly sworn, does hereby depose and <br />state: <br />1. That William G. Leiser, the decedent, died on December 31, 2017. <br />2. That at the time of death Decedent had an undivided one -thirtieth (1/30) <br />interest in real property described as follows: <br />The West Half of the Northwest Quarter (W1/2NW1/4) of Section Thirteen <br />(13), Township Eleven (11) North, Range Ten (10) West of the 6th P.M., <br />Hall County, Nebraska. <br />3. The Affiant, Sandra K. Leiser, is the person claiming as successor to the <br />Decedent's interest in real property in the State of Nebraska, as the surviving spouse of <br />the decedent. <br />4. The value of the decedent's interest in all real property in the estate of <br />William G. Leiser, Deceased, located in the State of Nebraska does not exceed Fifty <br />Thousand Dollars, ($50,000.00). <br />5. The value of Decedent's 1/30 interest in the above described real estate as <br />shown on the Hall County, Nebraska, tax assessment rolls for the year in which the <br />Decedent died, 2017, is $21,254. <br />6. The value of the entire estate of the Decedent, which consisted of assets in <br />the sole name of the Decedent or in which the Decedent held an interest as a tenant in <br />common is as follows: <br />Real Estate $21,254.00 <br />Personal Property $ 0.00 <br />Total $21,254.00 <br />7. Thirty days have elapsed since the death of the Decedent, which occurred <br />on December 31, 2017, as shown on the certified Death Certificate attached to this <br />affidavit. <br />