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<br /> �..' ST71TE OF NEBRASKA j ��,_.-._�--
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<br /> '' COUNTY OF HALL ) I � �
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<br />- � Affiant GRACE 8. ROMBACH after being firet duly sworn on t . �,,,., �r
<br /> �` oath, deposes and stataa as follows: ;;r,��`Tr�����,.j
<br /> ,.�,�r::�� •,:
<br /> ' ' 1. That Affiant is the surviving spouse of IAU F. ROMHACH, � �'�'
<br /> � � also knov�m as IAUIS F. ROMBACH, who di.ed l�pril 10, 1985, as ahown
<br /> � • � by the copy of the Decedent's dea�h certificate attached hereto as
<br /> � � Exhibit "�p and by this reference incorpoxated herein; that Exhibit ._
<br /> � "A" is a copy of the original Certificat� of Death on file with the
<br /> � '� Suresu of Vital Statistics, Departmer�t of Health, Sta�e of ;.�;,..
<br /> i�� Nebraska. �!���-
<br /> � � a�-
<br /> �;, Pj 2. That Affiant and tfie said Deced�nt were huaband and wife � � ��,c�� � •�.
<br /> ;�i ;,.,, on the da�te of the Decedent�a death on Apri 1 l0, 1985, anzi were on �; ;- �
<br /> ' said date �se sole ownera as j oint tenante not tenants in aommon, ' * � •,; .-_�`'��
<br /> � j • of the real esta�.e legally desaribed as follows: ; �' :-': `""�
<br /> ,, �,;� _ -=--°-
<br /> . j:� . , ;.
<br />' � ��!'"��� The Westerlp One-Half (W1/2) of Fractional I,ot Seven (7) , .�'���� ' . �=-�
<br /> � � in Fa�actional Block One Hundred Four (104) in Railroad � � -'�
<br /> Addition to the City of Grand Island, Hall County, ' . -
<br /> Nebraska, and its complement, to-wit: Fractional Lat i �: .,,. _
<br /> Seven (7) in Fractional Block One Hundrad Four (104) in , � _ , .
<br /> � Koen�ig and Wfabe�a Addition to the City of Grand Island, � � -
<br /> HalJ� County, Nebraska. "
<br /> , . (,
<br /> 3. That by reason of the provigions af the Joint Tenancy �
<br /> Warranty Deed, A�fiant became the sole owner of the above desaribed �
<br /> rrn�arty �n �?oar3er�t�s death. �`'
<br /> ;
<br /> 4. That this Aff3davit is given as evidence that pursuant to °
<br /> Neb.Rev.stat. section 77-2003, no inheritance �ax lien arising due
<br /> to the death of tt�e Decedent can attach to the above described rea3
<br /> estate and that pursuant to Neb.Rev.Stat. section 77-2012, no
<br /> Nebraska estate tax lien arising due to the death of the Decedent
<br /> " can at�ach to the above described property.
<br /> � FURTHER A�FIANT 3AYETH NOT. ' •
<br /> Dated December �u , 1991. '
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<br /> ' tr o-t-I-
<br /> ;.�t..�x�� .S h.s � , t
<br /> GRACE S. ROMBACH ,
<br /> SUBSCRIBED in my presence and sworn to before me Dece�abe� �, .
<br /> 1991. --� �C,.,- ��
<br /> 1 �---- ( ( (,.�..c,� � �.�_____�_�
<br /> ����''�0��� �otary P.0 ic � �
<br /> B.J.CUNNINGHAM.JR
<br /> AIY Comm EaD AuR 11. 155;, / ✓
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