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M <br />v <br />ell <br />rn <br />\ <br />= y <br />r, <br />o � <br />Ii <br />G <br />C D <br />N CD <br />n = <br />i7! > <br />O <br />O <br />A s <br />o <br />F� <br />1 <br />� -t •� <br />� <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, <br />and deposes and states that the undersigned knows the Decedent and <br />the surviving spouse of the Decedent and that the following <br />information is true and correct. <br />1. Name of Decedent: Sharon Tuma <br />Date of Death: January 19, 2003 <br />Domicile at Death: Wood River, Hall County, Nebraska <br />Name of Surviving Spouse: James W. Tuma, Sr. <br />Date of Marriage: July 22, 1972 <br />2. The Affiant is the daughter of the Decedent and, in that <br />capacity, is familiar with the marital status and the death of the <br />Decedent. <br />3. That there is no federal estate tax, Nebraska inheritance <br />tax or Nebraska estate tax due. <br />4. Title to the following described real estate is held by <br />the Decedent and the surviving spouse in joint tenancy, to -wit: <br />Lot One (1), Greenwood Subdivision, Hall County, <br />Nebraska. <br />5. As of the date of death, the real estate had a fair market <br />value of $144,846.00. <br />6. The Decedent and the surviving spouse were married as of <br />the date of death. There is no Nebraska inheritance tax lien by <br />reason of Nebraska Revised Statute §77 -2003. There is no Nebraska <br />estate tax lien by reason of Nebraska Revised Statute §77 -2102. <br />2003. <br />FURTHER Affiant saith not. <br />Valerie Loebig <br />Subscribed and sworn to before me this c.�y day of St , <br />C,ENEAAL IOT11RIf � 8me d <br />LOR N <br />I► & VAN8CHO�ACK <br />*CMU �Mae9.20 Notary Public <br />v <br />rn <br />\ <br />�= <br />o -cni <br />o � <br />Ii <br />C D <br />N CD <br />CD <br />O <br />O <br />m, <br />F� <br />1 <br />� -t •� <br />� <br />YI <br />�T <br />°2 <br />✓i <br />\ <br />.. <br />CD <br />G D <br />Ro <br />N <br />(n <br />i-A <br />cn <br />Z <br />O <br />COMES NOW, the undersigned, being first duly sworn upon oath, <br />and deposes and states that the undersigned knows the Decedent and <br />the surviving spouse of the Decedent and that the following <br />information is true and correct. <br />1. Name of Decedent: Sharon Tuma <br />Date of Death: January 19, 2003 <br />Domicile at Death: Wood River, Hall County, Nebraska <br />Name of Surviving Spouse: James W. Tuma, Sr. <br />Date of Marriage: July 22, 1972 <br />2. The Affiant is the daughter of the Decedent and, in that <br />capacity, is familiar with the marital status and the death of the <br />Decedent. <br />3. That there is no federal estate tax, Nebraska inheritance <br />tax or Nebraska estate tax due. <br />4. Title to the following described real estate is held by <br />the Decedent and the surviving spouse in joint tenancy, to -wit: <br />Lot One (1), Greenwood Subdivision, Hall County, <br />Nebraska. <br />5. As of the date of death, the real estate had a fair market <br />value of $144,846.00. <br />6. The Decedent and the surviving spouse were married as of <br />the date of death. There is no Nebraska inheritance tax lien by <br />reason of Nebraska Revised Statute §77 -2003. There is no Nebraska <br />estate tax lien by reason of Nebraska Revised Statute §77 -2102. <br />2003. <br />FURTHER Affiant saith not. <br />Valerie Loebig <br />Subscribed and sworn to before me this c.�y day of St , <br />C,ENEAAL IOT11RIf � 8me d <br />LOR N <br />I► & VAN8CHO�ACK <br />*CMU �Mae9.20 Notary Public <br />