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<br /> • � STAT� OF' NEHRA�Ei� )
<br /> '�-.�,'F�, ) 3B. �
<br />�-�,-`'.:��`.:-- COUN�`X �F �1RI�L ) Q
<br /> ' �`� �` CA:�� N�'r7, �IIa� ar.��ersa�er3, �a�i.ng duly sworn. depo�es and sa�s
<br /> '','� �`"-`�:.= that the tutdQraig��al as �s �anr�av�a.aa�f spause of t�c� ��c�al�an� a�al �R►��
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<br />-'-. ' '` �� the foll�u�s�q inf��3�i��n b� 'rxus ancl correot: ,
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<br /> _ .,,:��:: �. Nr�Q o� t��cede��: Danald L. Cati�E�11
<br />-,,'-`:'��;. �ate m� �aath: Jun� 6f 1993
<br /> „ , .
<br /> - � Doaicile a� Date of Dea�: Hall Cou�at��, �Iebraska
<br /> - -� ~�•� Nam� of Sinrviving Spouse: Dor�thy J. Caudill
<br /> •Y
<br /> - - Dato 08 Ma�riages February 27, 1946.
<br />-�-�=��'`"� 2, The Affiant is ralat�3 to the Decedent as �o2laws:
<br /> _`==����
<br /> _='�=�� eurviving sgouae.
<br /> _,;�;_.�;�-� 3. fittare ia no Fed2�L Eatate Tax, L�e�sasIti� Irr.��ri���aa�e Tax ar
<br />--••�_-'`�� tJ��SaaDta Egtat�e `�aza that ia due bQCause o� P���.���t�s dea�h.
<br /> - 4. Title t� �h� fo�,�winq described sre�3 �sta�e is held by the
<br /> -___---_--- Qeca�da�� and th� surviv��: epouse of thE H��Qde�� in joint �enancy,
<br /> -�=:=�;:� t��-wit s �
<br /> 11��`='�' Th� Wr��� &�alf (Wi/2j �� Lots F�oiarcteo� (14) and 3facteen
<br /> -�.��i (16� o �lozk F�ff��an (1�D, tJ11iv��sfty 1P1��a, Gsand I�l�tl.
<br /> Hail County, P�obraska. •
<br /> 5. Aa oP th� date of deat.�ao �.'�e ���►�. �st.��� Pr��s a �Yafr market �
<br /> - =y value og 575,�'�J.00.
<br /> 6. �� Deced�nt a�� APf�.ant w�ae n�.�ried 3s of date of deatti.
<br /> �h�r4 is nrr N�7�raska Iath�ritance �'ax ILn�n by reason of Nebraska
<br /> R�d�alsd StaEt�a�� Sgction 77°200�o ��aere is no Nebraska estate tax
<br /> ----_--�— li�e� by xeado�e �f N�bra��ce+ Revisee�.statu�es �ectfo� ��-2102.
<br /> - FtJ�'�H�R 2�iFPT�T�' S1�YTi�1 NOT. �
<br /> -- ----- — �
<br /> .-- =�u�� .
<br /> ��;��� Ooro y u
<br /> 4M� �abaaribed and �worn to befo�e me this �� day of January,
<br /> :`�=�;� 1999.
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<br /> �:T'�:�;�:�:� GFli�A1llf0TAflY•SIKa�H�tr�tt�
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