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m c,) 22 .Q4 Return to: Brandon S. Connick 104 N. Wheeler Avenue Grand Island, NE 68801 AFFIDAVIT FOR TRANSFER OF REAL PROPERTY WITHOUT PROBATE UNDER NEBRASKA PROBATE CODE The undersigned Affiant, being first duly sworn, does hereby depose and state pursuant to NEB. REV. STAT. §30-24,129 as follows: 1. The value of the one-half (1/2) interest held by DONALD P. CARTER, Deceased, in th? following described real estate did not exceed the sum of Fifty Thousand and No/1.00 Dollars ($0,000.00) as the then current assessed valuation of the entirety of said real estate on the date of hi death as shown on the assessment rolls in the Office of the Hall County Assessor for the year 2il16 was Nineteen Thousand Four Hundred Thirty -Eight and No/100 Dollars ($19,438.00): The East 24 feet of Lot 10, in Block 20, Original Town of Wood River, Hall County, Nebraska, also known as 108 West 9th Street, Wood River, Nebraska. 2. Thirty (30) days have elapsed since the death of the Decedent on September 21, 2016 as shown by the certified copy of the decedent's death certificate attached hereto as Exhibit "A" an incorporated herein by this reference. 3. No application or petition for the appointment of a personal representative is pending or has been granted in any jurisdiction. 4. Affiant, as the surviving spouse of Donald P. Carter, Deceased, is entitled to the real property described hereinabove at Paragraph 1 by virtue of intestate succession. 5. Affiant has made an investigation and has been unable to determine any will of the D: cedent. 6. No other person has a right to the interest of the Decedent in the real estate described he einabove at Paragraph 1. 7. The Affiant, GWENDOLYN JANICE CARTER is the surviving spouse of DONALD P. (ARTER, Deceased, there being no other persons entitled to any portion of his estate at the oN 1N3Wf i1SN! syZ.