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0 m1 <br />A Fw <br />� o <br />mN <br />iJ <br />O <br />STATE OF NEBRASKA <br />COUNTY OF DAWSON <br />fi <br />r <br />c <br />z n <br />n x <br />x <br />n n <br />rmi to <br />• <br />iv <br />\; <br />cn <br />N <br />U1 <br />(i <br />AFFIDAVIT OF DEATH OF JOINT TENANT\ <br />ss. <br />(.rl <br />BARBARA BOOS, of legal age, being duly sworn, deposes and says: <br />c > <br />z -a <br />� m <br />o T <br />U� <br />D <br />N <br />0 <br />O <br />N <br />N <br />n� <br />y <br />z <br />w <br />v_F <br />H <br />F <br />0 <br />1. Marcella Elizabeth Luton died on March 11, 1979, as described in the attached copy <br />of the Certificate of Death. o, <br />2. Affiant is the daughter of the decedent. <br />3. Daniel Luton was the surviving spouse of the decedent and was married to said <br />decedent at the date of decedent's death. <br />4. No gifts in contemplation of death were made by the decedent. <br />5. That the value of all real and personal property owned by the Decedent at date of <br />death, including the full value of the property described in Paragraph 6 herein, did not exceed <br />the sum of Six Hundred Thousand Dollars ($600,000.00). <br />6. There is no Federal Estate Tax, Nebraska Inheritance Tax or Nebraska Estate Tax <br />due from the estate of decedent. <br />to -wit: <br />7. Decedent owned in joint tenancy with the Affiant the following described real estate, <br />Lot Seven (7), Block Three (3), College Addition to Westlawn, Grand Island, Hall <br />County, Nebraska. <br />8. There is no Nebraska Inheritance Tax lien by reason of Nebraska Statute Section 77- <br />2003 and no Nebraska Estate Tax lien by reason of Nebraska Statute 77 -2102. <br />FURTHER, AFFIANT SAITH NOT. <br />Dated this \,\ day of , 2002. <br />SUBSCRIBED AND SWORN to before me this IV' day of gt o l L r 2002, by <br />BARBARA BOOS. <br />� �E TARq �ry a Notary Public <br />myCanm. ft NO.5, YW5 <br />prob \dlut3.kp <br />Hart, Dawson & Sudbeck, P.C., LL0, <br />Cozad,, Nebraska <br />