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ormimem <br />N111M11.11111.01 <br />CS) <br />Return to: <br />Denise D. Myers <br />P.O. Box 505 <br />Cairo, NE 68824 <br />AFFIDAVIT OF MARITAL STATUS <br />STATE OF NEBRASKA <br />) ss. <br />COUNTY OF HALL <br />COMES NOW, the undersigned, being first duly sworn upon oath, and deposes and states <br />that the undersigned knows the Decedent and the surviving spouse of the Decedent and that the <br />following information is true and correct. <br />1. Name of Decedent: Linda K. Matthes <br />Date of Death: January 16, 2022 <br />Domicile at Death: Cairo, Hall County, Nebraska <br />Name of Surviving Spouse: John H. Matthes <br />Date of Marriage: April 5, 1982 <br />2. The Affiant is the attorney for the decedent and her spouse, and in that capacity, is <br />familiar with the marital status and the death of the Decedent. <br />3. That there is no federal estate tax, Nebraska inheritance tax or Nebraska estate tax <br />due. <br />4. Title to the following described real estate is held by the Decedent and the surviving <br />spouse in joint tenancy, to -wit: <br />Lot Eleven (11), Centura Hills Subdivision, an Addition to the Village of Cairo, Hall <br />County, Nebraska. <br />5. As of the date of death, the real estate had a fair market value of $330,770. <br />6. The Decedent and the surviving spouse were married as of the date of death. There <br />is no Nebraska inheritance tax lien by reason of Nebraska Revised Statute §77-2003. <br />FURTHER Affiant sayeth not. <br />Denise D. Myers <br />i�- <br />Subscribed and sworn to before me this day of F ` cu. , 2022. <br />GENERAL NOTARY -State of Nebraska <br />SUSAN R. MRKVICKA <br />My Comm. Bp. June 8, 2025 <br />Ysfyuki <br />Notary Public <br />