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Return to: <br />Galen E. Stehlik <br />P.O. Box 400 <br />Grand Island, NE 68802-0400 <br />= D <br />N <br />AFFIDAVIT OF MARITAL STATUS <br />STATE OF NEBRASKA ) <br />) ss. <br />COUNTY OF HALL ) <br />rn <br />---1 <br />rn <br />• <br />fV <br />=c "' co <br />ILonN <br />O... <br />f -� Z <br />C7 O <br />`ate <br />r-, o rn <br />ti <br />CO <br />C> <br />COMES NOW, the undersigned, being duly sworn, deposes and says that the undersigned is the <br />surviving spouse of the Decedent and that the following information is true and correct: <br />1. Name of Decedent: Jim L. Tuma <br />Date of Death: <br />December 28, 2020 <br />Domicile at Date of Death: Grand Island, Hall County, Nebraska <br />Name of Surviving Spouse: Mary Kay Tuma <br />Date of Marriage: June 25, 1977 <br />2. The Affiant is related to the Decedent as follows: Surviving Spouse. <br />3. There is no Federal Estate Tax, Nebraska Inheritance Tax or Nebraska Estate Tax that is due <br />because of Decedent's death. <br />4. Title to the following described real estate is held by the Decedent and the surviving spouse of <br />the Decedent in joint tenancy, to -wit: <br />Lot Two (2), Summerfield Estate Sixth Subdivision, in the City of Grand <br />Island, Hall County, Nebraska. <br />5. As of the date of death, the real estate has a fair market value of $373,070.21. <br />6. The Decedent and Affiant were married as of date of death. There is no Nebraska Inheritance <br />Tax lien by reason of Nebraska Revised Statutes Section 77-2003. There is no Nebraska estate tax lien by <br />reason of Nebraska Revised Statutes Section 77-2102. <br />FURTHER AFFIANT SAITH NOT. <br />aittLkv <br />4k <br />SUBSCRIBED and SWORN to before me this j day of March, 2021. <br />GENEM1. NOTARY - State of Nebraska <br />CHERYL P. TUSTIN <br />My Comm. Exp. November 9, 2022 <br />