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202101 ,on <br />STATE OF NEBRASKA ) <br />ss <br />COUNTY OF ) <br />(county in which the document will be signed) <br />Affidavit for Transfer of Real Property without Probate <br />I, Dorla Jean Bickford , under penalty of perjury (Nebraska Revised Statute § 28-915), <br />(your name) <br />affirm the following to be true: <br />1. Thirty days have passed since the death of Ronald L. Bickford and I have attached <br />(deceased's name) <br />to this affidavit a certified or authenticated copy of the death certificate; <br />2. The deceased is the sole owner of the real property described as <br />Lot Three (3) in Block Five in Gilbert's Addition to the City of Grand Island, Hall County, Nebraska <br />3. Based on the assessed value of the real property through the County Assessor/Register of Deeds in <br />the year of death, less real estate taxes and interest on real estate taxes if any is due at the time of <br />death, the value of all the real property in Nebraska belonging to the deceased is <br />$50,000.00 or less and the value of the entire estate (real property value plus personal property <br />value) is $ 48,491.00 <br />4. There is no Personal Representative, application for Personal Representative, or petition for <br />Personal Representative either pending or granted in another court; <br />5. OX I am the Surviving Spouse of the deceased and am entitled to the real <br />(your relationship to the deceased) <br />property by reason of the homestead allowance, exempt property allowance, family allowance, or <br />by intestate succession pursuant to Nebraska Probate Code § 30-24,129; <br />OR <br />❑ I am entitled to the real property per the will of the deceased and I have made an <br />investigation and have been unable to determine any subsequent will; <br />6. No other person has a right to the real property; <br />7. I will file this affidavit with the Register of Deeds Office of the county in which the real property is <br />located ( Hall County); and <br />8. I will file the affidavit and certified or authenticated copy of the death certificate in any other county in <br />Nebraska in which the deceased owns real property that is subject to this affidavit. <br />Page 1 of 2 <br />Affidavit for Transfer of Real Property without Probate <br />CC 15:41 New 07/14 <br />Pro Se Committee <br />Neb. Rev. Stat. §30-24,129 <br />