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<br /> AFFIDAVIT OF MARITAL STAT[TS G
<br /> . STATE OF �. , � ) ,
<br /> .. ; SS:
<br /> COTJNTY O�',.
<br /> COMES NOW, the undersigned, being duly sworn, depases.
<br /> �� � and says� -'�hat the uiidersigned knows the Decedent and the
<br /> surviving spouse of the Decedent and that the followinq
<br /> information is true and cor:ect: �
<br /> 1. Name of Decedent: Helen M. Simpson ,
<br /> Date of Death: 3une 14, 1985
<br /> Domicile at Date of Deat;h: Hall County, Nebraska
<br /> Name of Surviving 3pouse: Harley L. Simpsnn
<br /> Date of Marriaqe: September 1, 1925
<br /> 2. The Affiant is relat�d to the Decedent as follows:
<br /> son ,
<br /> 3. There is no Federal Estate Tax, Nebraska Inheritance
<br /> Tax or Nebraska Estate Tax.
<br /> 4. Title to th� followinq described real Estate is held
<br /> by the Decedent and the surviving spouse of the
<br /> Decedent in join� tenancy, to wit:
<br /> Lot Two (2) , in �loc$ Five (5), in schimmer�s
<br /> ' Addition to 'the City cf Grand Islar�d, Hall
<br /> County, Nebraska.
<br /> 5. . . �As of da�e oE death, the real" estate has a' f�air market �
<br /> value of $56,550.00.
<br /> 6. The Decedent and Harley .i,. Simpson were married as of
<br /> date of death. There is no Nebraska..Inher.itance Tax
<br /> � � � 'lien b� reason� of Nebraska Revised Statutes Sect3on
<br /> 77-2003. There is no Nebraska estate t�x lien by ..
<br /> reason of Nebraska Revised Statutes Sec�ion 77-2102.�
<br /> FURTHER Affiant saith t.
<br />. � •
<br /> ' (�.
<br /> Ly e w. Simpson, AfPiant
<br /> ubscribed and sworn to before me this � day of •
<br /> _ �\'(� �5� , 1995.
<br /> �� � . , �
<br /> � .� �C �, ,
<br /> � Notary + ub c
<br /> �
<br /> ` .. , . . . . . I
<br /> ` � ,� �.
<br />
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