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! M '71 C z ry c� ! CC N J IN � STATE OF NEBRASKA) ) ss. COUNTY OF HALL ) z M Cn n z 7� I • AFFIDAVIT OF DEATH William A. Francis, being first duly sworn upon oath, deposes and states as follows: 1. That the undersigned Affiant is of legal age and a resident of Grand Island, Hall County, Nebraska. 2. That attached hereto marked Exhibit "A" and incorporated herein by reference, appears a copy of the Death Certificate of Roy E. Hofrichter issued by the Nebraska Department of Health and Human Services System. 3. That on his death, Roy E. Hofrichter was survived by his spouse, Wanda W. Hofrichter, and was the owner of the real estate described as: The Northeast Quarter (NE1 /4) of Section Twenty (20), Township Ten (10) North, Range Eleven (11), West of the 6th P.M., Hall County, Nebraska, less that portion of the Quarter deeded as a cemetery in Instruments No. 86- 005553 and 86- 005554 recorded in the Office of the Hall County Register of Deeds, and less the property in said Quarter deeded by Instruments No. 92- 106419 and 96- 104202 recorded in the Office of the Hall County Register of Deeds. Further Affiant sayeth not. William A. Francis, Affiant The above and foregoing Affidavit dvaa executed and acknowledged before me on the I— day of 2004, by William [XW0%1WTJAY - Sra�e of N�raalca EGINA R. Ol3EN MY Comm. EV. Oct 27,2W PROBATEI HOFRICHT.AFF ary Public i.. J r� t r; C0 -! n. CD Cn t� � 2 C1'1 D O cn rf, GO Z 0 William A. Francis, being first duly sworn upon oath, deposes and states as follows: 1. That the undersigned Affiant is of legal age and a resident of Grand Island, Hall County, Nebraska. 2. That attached hereto marked Exhibit "A" and incorporated herein by reference, appears a copy of the Death Certificate of Roy E. Hofrichter issued by the Nebraska Department of Health and Human Services System. 3. That on his death, Roy E. Hofrichter was survived by his spouse, Wanda W. Hofrichter, and was the owner of the real estate described as: The Northeast Quarter (NE1 /4) of Section Twenty (20), Township Ten (10) North, Range Eleven (11), West of the 6th P.M., Hall County, Nebraska, less that portion of the Quarter deeded as a cemetery in Instruments No. 86- 005553 and 86- 005554 recorded in the Office of the Hall County Register of Deeds, and less the property in said Quarter deeded by Instruments No. 92- 106419 and 96- 104202 recorded in the Office of the Hall County Register of Deeds. Further Affiant sayeth not. William A. Francis, Affiant The above and foregoing Affidavit dvaa executed and acknowledged before me on the I— day of 2004, by William [XW0%1WTJAY - Sra�e of N�raalca EGINA R. Ol3EN MY Comm. EV. Oct 27,2W PROBATEI HOFRICHT.AFF ary Public i.. J