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CS) <br />0 <br />N� <br />CD <br />CA▪ ) <br />.> ry <br />r-. <br />Cr▪ ) <br />_� <br />r s N) <br />rT.� <br />r;i _ - C:; <br />-- <br />•O <br />C.1 Ca <br />Return to: Denise Myers <br />P.O. Box 505 <br />Cairo, NE 68824 <br />AFFIDAVIT OF MARITAL STATUS <br />STATE OF NEBRASKA ) <br />) ss. <br />COUNTY OF HALL ) <br />COMES NOW, the undersigned, being first duly sworn upon oath, and deposes <br />and states that the undersigned knows the Decedent and the surviving spouse of the <br />Decedent and that the following information is true and correct. <br />1. Name of Decedent: Richard Nabity <br />Date of Death: January 12, 2020 <br />Domicile at Death: Grand Island, Hall County, Nebraska <br />Name of Surviving Spouse: Annette M. Nabity <br />Date of Marriage: October 6, 1962 <br />2. The Affiant is the attorney for the Decedent's spouse and, in that capacity, is <br />familiar with the marital status and the death of the Decedent. <br />3. That there is no federal estate tax, Nebraska inheritance tax or Nebraska <br />estate tax due. <br />4. Title to the following described real estate is held by the Decedent and the <br />surviving spouse in joint tenancy, to -wit: <br />Lots Six (6) and Seven (7), in Block Four (4), in Ashton Place, an Addition <br />to the City of Grand Island, Hall County, Nebraska. <br />5. As of the date of death, the real estate had a fair market value of $151,013. <br />6. The Decedent and the surviving spouse were married as of the date of death. <br />There is no Nebraska inheritance tax lien by reason of Nebraska Revised Statute §77- <br />2003. <br />FURTHER Affiant saith not. <br />Denise D. Myers <br />Subscribed and sworn to before me this <br />k <br />ENER SUSAN R.NOTARY -MRKVICKAte of ka <br />My Comm. Exp. June 8, 2021 <br />$ — day of February, 2020. <br />�:?1,� <br />Notary Public <br />