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8Z6500ZOZ Return to: Jamie Mues Jankovitz 202 W. 3rd St. Grand Island, NE, 68801 AFFIDAVIT OF MARITAL STATUS AND DEATH CERTIFICATE Cr) Comes Now, the undersigned, being first duly sworn upon oath, deposes and states that the undersigned knows the Decedent and the surviving spouse of the Decedent and that the following information is true and correct. 1. Name of Decedent: Nancy S. Knapp Date of Death: May 24, 2020 Domicile at Death: Hall County, Nebraska Name of Surviving Spouse: John W. Knapp Date of Marriage: July 18 1971 2. The Affiant is the husband of the Decedent and in that capacity is familiar with the marital status and the death of the Decedent. 3. That there is no federal estate tax, Nebraska inheritance tax or Nebraska estate tax due. 4. Title to the following described real estate is held by the Decedent and the surviving spouse in joint tenancy, to wit: Lots Sixty (60) and Sixty One (61), in West Lawn, an addition to the City of Grand Island, Hall County, Nebraska (Physical Address: 1810 Park Ave., Grand Island, Nebraska). 5. As of the date of death, the real estate had a fair market value of$180,660.00. 6. The Decedent and the surviving spouse were married as of the date of death. There is no Nebraska inheritance tax lien by reason of Nebraska Revised Statute § 77-2003. There is no Nebraska estate tax lien by reason of Nebraska Revised Statute §77-2102. FURTHER THIS AFFIANT SAYETH N STATE OF NEBRASKA ) ss: COUNTY OF HALL Joh Knapp, Affia SUBSCRIBED and sworn to before me on this 5day of John W. Knapp, Affiant. PREPARED BY: Jamie Mues Jankovitz, #20754 BRADLEY LAW OFFICE, PC 202 West Third Street Grand Island, NE 68801 Telephone: (308) 382-2128 Jamie@hradleylawotfice. com f , 2020 by Notary 'ublic GENERAL NOTARY - State of Nebraska l ALLISON R JONAK My Comm. Exp. Apdi 14, 2024 rn rn rn Lel 71,3 f H