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STATE OF NEBRASKA <br />ss. <br />COUNTY OF HALL ) <br />0 <br />0 <br />COMES NOW, the undersigned, being duly sworn, deposes and states <br />that the undersigned is the surviving spouse of the Decedent, and that <br />the following information is true and correct: <br />1. Name of Decedent: Della Mary Fowle <br />Date of Death: September 14, 2000 <br />Domicile at Date of Death: Hall County, Nebraska <br />Date of Marriage: November 13, 1936 <br />2. The Affiant is the surviving spouse of the decedent. <br />3. There is no Federal Estate Tax, Nebraska Inheritance Tax or <br />Nebraska Estate Tax that arose, or can arise, by virtue of the <br />Decedent's death. <br />4. Title to the following described real estate was held by the <br />Decedent and George E. Fowle, the Decedent's spouse, and Larry W. <br />Fowle, Decedent's son, on the date of the Decedent's death, to -wit: <br />The West Half of Lot Eight -six (86) and all of Lot Eighty -seven <br />(87), in Hagges' Subdivision in the City of Grand Island, Hall <br />County, Nebraska. <br />5. As of the date of death, the real estate has a fair market <br />value of $59,523.00. <br />6. The Decedent and George E. Fowle were married as of the date <br />of death of Della Mary Fowle. There is no Nebraska Inheritance Tax <br />lien, and no Nebraska inheritance tax lien. <br />AND FURTHER AFFIANT SAITH NOT. <br />_ 4- <br />George Fowle <br />Subscribed and sworn to before me this of October, 2000. <br />GENERAL NOTARY -State of Nebraska <br />ill SHERRY SGES <br />My Comm. ip o t a r y Pub c OAJ <br />ESTATES \A- MARITAL.AFF <br />S D <br />rn <br />T <br />c7 <br />�:o <br />7 <br />X <br />ran <br />cif <br />v <br />C5 <br />Fri <br />M <br />D <br />OC) <br />C <br />n <br />f" <br />p� <br />co <br />C <br />CD <br />D <br />CI1 <br />CJl <br />to <br />C 0 <br />CD <br />r=-r <br />� <br />Z <br />Q <br />200008659 <br />AFFIDAVIT <br />OF MARITAL STATUS <br />STATE OF NEBRASKA <br />ss. <br />COUNTY OF HALL ) <br />0 <br />0 <br />COMES NOW, the undersigned, being duly sworn, deposes and states <br />that the undersigned is the surviving spouse of the Decedent, and that <br />the following information is true and correct: <br />1. Name of Decedent: Della Mary Fowle <br />Date of Death: September 14, 2000 <br />Domicile at Date of Death: Hall County, Nebraska <br />Date of Marriage: November 13, 1936 <br />2. The Affiant is the surviving spouse of the decedent. <br />3. There is no Federal Estate Tax, Nebraska Inheritance Tax or <br />Nebraska Estate Tax that arose, or can arise, by virtue of the <br />Decedent's death. <br />4. Title to the following described real estate was held by the <br />Decedent and George E. Fowle, the Decedent's spouse, and Larry W. <br />Fowle, Decedent's son, on the date of the Decedent's death, to -wit: <br />The West Half of Lot Eight -six (86) and all of Lot Eighty -seven <br />(87), in Hagges' Subdivision in the City of Grand Island, Hall <br />County, Nebraska. <br />5. As of the date of death, the real estate has a fair market <br />value of $59,523.00. <br />6. The Decedent and George E. Fowle were married as of the date <br />of death of Della Mary Fowle. There is no Nebraska Inheritance Tax <br />lien, and no Nebraska inheritance tax lien. <br />AND FURTHER AFFIANT SAITH NOT. <br />_ 4- <br />George Fowle <br />Subscribed and sworn to before me this of October, 2000. <br />GENERAL NOTARY -State of Nebraska <br />ill SHERRY SGES <br />My Comm. ip o t a r y Pub c OAJ <br />ESTATES \A- MARITAL.AFF <br />