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C. <br />L <br />r <br />F —+ <br />}.s <br />CIl <br />Return to: <br />Denise D. Myers <br />P.O. Box 505 <br />Cairo, NE 68824 <br />STATE OF 14brQskc` <br />COUNTY OF I b I� <br />AFFIDAVIT FOR TRANSFER <br />OF REAL PROPERTY WITHOUT PROBATE <br />UNDER NEBRASKA PROBATE CODE <br />Section 30-24,129 <br />) ss. <br />The undersigned Affiants, upon being first duly sworn, do hereby depose and state: <br />1. That Ethel BeIIe Rezabek, the decedent, died on January 28, 2010. At the time of <br />her death Ethel BeIIe Rezabek had a surviving spouse, Carl A. Rezabek, and five surviving <br />children, namely Kenneth W. Ross, Peggy J. Walter, Allan C. Ross, Randall D. Ross and Debra <br />S. Jarzynka. <br />2. That at the time of death Decedent had an undivided one-half (1/2) interest in the real <br />property described as follows: <br />The Northeast Quarter of the Northwest Quarter (NE1/4NW1/4) of Section Twenty- <br />three (23), Township Eleven (11) North, Range Twelve (12), West of the 6th P.M., <br />Hall County, Nebraska. <br />3. The Affiants, Kenneth W. Ross, Peggy J. Walters, Allan C. Ross, Randall D. Ross, <br />Debra S. Jarzynka, and the Estate of Carl Rezabek are the persons claiming as successors to <br />the Decedent's interest in real property in the State of Nebraska, as the surviving children and <br />surviving spouse of the decedent, who died intestate. <br />4. The value of the decedent's interest in all real property in the estate of Ethel Belle <br />Rezabek, Deceased, located in the State of Nebraska does not exceed Fifty Thousand Dollars, <br />1 <br />