202006976 - Laserfiche WebLink

Browse

202006Y7e STATE OF NEBRASKA COUNTY OF i4-a(k (county in which the document will be signed) Affidavit for Transfer of Personal Property without Probate I, Arlt -et Rod) n uez Gaora , under penalty of perjury under Nebraska Revised Statute § 28-915, (your na ) swear or affirm the following to be true and material: 1. thirty days have passed since hikk4-o U y TZ.Nt,n-b 's death; (deceased's name) 2. a certified or authenticated copy of the deceased's death certificate is attached to this affidavit; 3. the value of the entire estate of the deceased, /14\44-1-c tWa 2e no , less liens and (deceased's name) encumbrances (claims against or on the property), is $50,000.00 or less; 4. there is no Personal Representative, application for Personal Representative, or petition for Personal Representative; and 5. I am entitled to A-1 u VN ✓ (deceased's name) relationship as payment and delivery of all property held by others in the sole name of the deceased, Qe vvo , pursuant to Nebraska Probate Code § 30-24,125 and because of my 6 .)usQ to the deceased. As provided under Nebraska Probate Code § 30-24,126, the person releasing personal property or the evidence of property based upon this affidavit is discharged and released just as if that person dealt with a Personal Representative of the deceased. The person releasing the property is not required to see to the application of the personal property or evidence of that application or to inquire into the truth of any statement in this affidavit. A transfer agent of any security shall change the registered ownership on the books of a corporation from the decedent to the successor or successors upon the presentation of the affidavit. Date Signature /1/4 T //4 3 .oc ,8001,06-i?A 5'/ Address (line 1) FRAC. 6-4 , i/I A) d ,Qv,1)17`‘)9v. a Address (line 2),1107-6.4 tc//oAc4.t- (o) NOTARY 11^ State of Nebraska, County of tW .1 This document was acknowledged, sworn to, or affirmed before me on the iI\ day of , 20,20 , by 1tkc_ R.c vlqutz, G0.orix. . (day) month) (ye- (Affiantiename) (do NOT sign U TIL A NOTARY IS PRESENT AND WITNESSES YOU SIGNING) ® ipiGENERAL NOTARY - Ste Nebraska Jed + TRACY L OVERSTREREET GARTNER My Comm. Exp. October 27, 2020 Page 1 of 1 Affidavit for Transfer of Personal Property without Probate CC 15:40 Rev. 06/19 Pro Se Committee Signat f of ota My commission expires: /0 '(3? , if any) 7 -07602 o