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Z �.. i `� o - U •(TS xai rA t N C N -� N :3 N AFFIDAVIT '® STATE OF NEBRASKA ) 200212109 ss. COUNTY OF HALL ) Affiant, MARTHA S. CONANT, after being first duly sworn on oath, deposes and states as follows: 1. That Affiant is the surviving spouse of JOHN H. CONANT, who died July 15, 1999, as shown by the certified copy of the Decedent's death certificate attached hereto as Exhibit "A" and by this reference incorporated herein; that Exhibit "A" is a certified copy of the original Certificate of Death on file with the Bureau of Vital Statistics, Department of Health, State of Nebraska. 2. That Affiant and the said Decedent were husband and wife on the date of the Decedent's death on July 15, 1999, and were on said date the sole owners as joint tenants not tenants in common, of the real estate legally described as follows: Part of Lot 13 of the County Subdivision of the South Half of the Southeast Quarter of Section 16, in Township 11 North, Range 9 West of the 6th P.M., Hall County, Nebraska, more particularly described as follows: Commencing at a point on the Southerly side of said Lot 13, 105 feet Easterly from the Southwest corner thereof, running thence Easterly on said Southerly side of said Lot, for a distance of 66 feet, thence Northerly at right angles for a distance of 180 feet, running thence Westerly at right angles for a distance of 66 feet, and running thence Southerly at right angles for a distance of 180 feet to the place of beginning, subject to the Northerly Half of the 80 foot Street, known as Louise Street, in the City of Grand Island, Nebraska, lying immediately Southerly of and adjacent to the above described premises. 3. That by reason of the provisions of the Joint Tenancy Warranty Deed, Af f iant became the sole owner of the above described property on Decedent's death. 4. That this Affidavit is given as evidence that pursuant to Neb.Rev.Stat. section 77 -2003, no inheritance tax lien arising due to the death of the Decedent can attach to the above described real estate and that pursuant to Neb.Rev.Stat. section 77 -2012, no Nebraska estate tax lien arising due to the death of the Decedent can attach to the above described property. FURTHER AFFIANT SAYETH NOT. uaLv.l 8 _ !j , 20Cjw+ MART S. CONANT SUBS�PIBED in my presence and sworn to before me this day of I 2 0 qp% � y Not r�b is _ $