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MST 2023 0LI003 <br />Return to: Law Office of Eurek & Peterson LLC, P 0 Box 310, Loup City, NE 68853 <br />AFFIDAVIT OF MARITAL STATUS <br />STATE OF NEBRASKA ) <br />) SS. <br />COUNTY OF SHERMAN ) <br />CASH n <br />CHECK ? aJ0 <br />REFUNDS: <br />CASH <br />CHECK <br />HA_! NE <br />2023 <br />• 50 <br />REGISTER OF DEEDS <br />COMES NOW, the undersigned, being duly sworn, deposes and says that he is <br />the surviving spouse of the Decedent and that the following information is true and <br />correct: <br />1. Name of Decedent: Julie A. Stevenson <br />Date of Death: June 3, 2017, see Exhibit A for certified death certificate <br />Domicile at Date of Death: Sherman County, Nebraska <br />Personal Representative of the Surviving Spouse: John M. Stevenson <br />Date of Marriage: May 24, 1986 <br />The Affiant is related to the Decedent as follows: spouse of the Decedent. <br />2. All Federal Estate Tax, Nebraska Inheritance Tax or Nebraska Estate Tax <br />that was due and owing has been paid. <br />3. Title to the following described real estate is held by the Decedent and the <br />