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N <br />n <br />_ :> <br />n; Ln <br />n 1 <br />Return to: i <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: Pauline K. Bolles <br />Date of Death: January 28, 2022 <br />Domicile at Death: Grand Island, Hall County, Nebraska <br />Name of Surviving Spouse: Garry W. Bolles <br />Date of Marriage: April 13, 1961 <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 Fourteen (14), Block Two (2), Pleasant View Addition to the City of Grand <br />Island, Hall County, Nebraska. <br />The northerly Eighteen Feet (N18") of Lot Three (3), and all of Lots Four (4) and <br />Five (5), Block Seventeen (17), Packer & Barr's Second Addition to the City of <br />Grand Island, Hall County, Nebraska. <br />Lots One (1) and Two (2), Block Three (3), Kernohan & Decker's Addition; that part <br />of vacated Broadwell Avenue lying west of and adjacent to said Lots One (1) and <br />Two (2), Block Three (3) lying South of Front Street and north of the alley in said <br />Block Three (3), in the City of Grand Island, Hall County, Nebraska. <br />5. As of the date of death, the real estate had a fair market value of $400,259.00. <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 />f <br />Subscribed and sworn to before me this 1st day of April, 2022. <br />Notary Public <br />GENERAL NOTARY - State of Nebreska <br />SUSAN R. MRKVICKA <br />L My Comm. Exp. June 8, 2025 <br />