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N.) <br />cn <br />�I ' <br />1- • <br />N <br />Do not write above this line, for filing purposes only <br />Dier, Osborn & Cox, P.C., L.L.O., 419 East Avenue, P.O. Box 586, Holdrege, Nebraska 68949-0586 <br />AFFIDAVIT FOR TRANSFER OF REAL PROPERTY <br />WITHOUT PROBATE UNDER NEBRASKA PROBATE CODE <br />STATE OF NEBRASKA ) <br />) ss. <br />COUNTY OF PHELPS ) <br />The undersigned Affiant, being first duly sworn upon oath, deposes and <br />states as follows: <br />1. Max Everett Heinz died on February 5, 2020, a resident of <br />Washougal, WA 98671. <br />2. At the time of the Decedent's death, Decedent was the owner of <br />and/or had an interest in the following -described real property, to -wit: <br />Lot 16, Argo Fourth Subdivision in the Village of Alda, Hall <br />County, Nebraska <br />3. The value of Decedent's interest in all real property in the <br />decedent's estate located in the State of Nebraska does not exceed fifty thousand <br />dollars ($50,000.00). <br />4. The value of Decedent's interest in the above-described real property <br />is determined from the value of the property as shown on the assessment rolls <br />for the year in which the Decedent died, said assessed value being $33,629.00. <br />5. Thirty days have elapsed since the death of the above-named <br />Decedent, as shown in the certified or authenticated copy of the Decedent's death <br />