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6V9Z06Z0Z <br />STATE OF NEBRASKA <br />) ss. <br />COUNTY OF HALL <br />73 nn <br />ni T > <br />c i <br />c <br />n inT/1W <br />AFFIDAVIT FOR TRANSFER OF <br />REAL ESTATE WITHOUT <br />ESTATE ADMINSTRATION <br />Section 30-24,129 (Reissue 2016) <br />The undersigned Affiants, upon being first duly sworn, depose and state: <br />r r� <br />1. Annette Arlene Smith died January 8, 2021 at the age of 66 years. She was a <br />resident of Hall County, Nebraska. <br />2. The value of the decedent's interest in all real property in the decedent's estate <br />located in the State of Nebraska or elsewhere does not exceed $50,000.00 as determined from the <br />value of the property as shown on the assessment roll for 2021. Her entire interest in real estate <br />in the State of Nebraska is the ownership of the following described real estate: <br />Lot Three (3), in Block Six (6), in Claussen Country View Addition to the City of <br />Grand Island, Hall County, Nebraska. <br />3. Thirty (30) days have elapsed since the death of the decedent as shown on a <br />certified copy of the decedent's death certificate attached hereto and incorporated herein by <br />reference. <br />4. No application or petition for the appointment of a Personal Representative is <br />pending or has been granted in any jurisdiction. <br />1 <br />a..� <br />