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rn <br />c <br />S rTl <br />`iJ y Q7 <br />O <br />Return to: Arend R. Baack <br />104 N. Wheeler Avenue <br />Grand Island, NE 68801 <br />AFFIDAVIT FOR TRANSFER <br />OF REAL PROPERTY WITHOUT PROBATE <br />UNDER NEBRASKA PROBATE CODE <br />The undersigned Affiants, being first duly sworn, does hereby depose and state pursuant <br />to NEB. REV. STAT. §30-24,129 as follows: <br />1. The value of the interest held by LETHA J. MCINTOSH, Deceased in the following <br />described real estate did not exceed the sum of Fifty Thousand and No/100 Dollars ($50,000.00) <br />as the then current assessed valuation of said real estate on the date of her death as shown on the <br />assessment rolls in the Office of the Hall County Assessor for the year 2019 was Twenty -Three <br />Thousand Nine Hundred Twelve and No/100 Dollars ($23,912.00): <br />Lot Two (2), Bartlett Subdivision to the Village of Alda, Hall County, Nebraska. <br />2. Thirty (30) days have elapsed since the death of the Decedent on August 30, 2019 as <br />shown by the certified copy of the decedent's death certificate attached hereto as Exhibit "A" and <br />incorporated herein by this reference. <br />3. No application or petition for the appointment of a personal representative is pending <br />or has been granted in any jurisdiction. <br />4. Affiants, as the sole surviving heirs of LETHA J. MCINTOSH, Deceased, are entitled <br />to the real property described hereinabove at Paragraph 1 by virtue of intestate succession or <br />devise under the will of the decedent. <br />5. Affiants have made an investigation and have been unable to determine any <br />subsequent will. <br />6. No other person has a right to the interest of the Decedent in the real estate described <br />hereinabove at Paragraph 1. <br />7. The Affiants, JESSICA A. VALASEK and ROBERT E. MCINTOSH are the only <br />children of LETHA J. MCINTOSH, Deceased, there being no other persons entitled to any <br />ENTERED AS INSTRUMENT NO <br />