Laserfiche WebLink
�~ <br />r <br />X <br />0 <br />rl <br />U> <br />O ---i <br />rna <br />d <br />cm7 � <br />' <br />CZ) <br />r <br />n <br />IV <br />c� " <br />hr-` <br />CA <br />, <br />7- TTI <br />J <br />m f <br />© <br />N <br />�5' <br />co <br />Q7- <br />ry <br />ro <br />C.a <br />Co <br />�N <br />0 <br />r-r� <br />z <br />200502328 <br />AFFIDAVIT OF MARITAL STATUS <br />STATE OF NEBRASKA ) <br />) ss. <br />COUNTY OF HALL ) <br />Affiant, Diane L. Clatterbuck, after being duly sworn upon oath, does depose and <br />state as follows: <br />1. That affiant is the surviving spouse of John D. Clatterbuck ( "decedent "), <br />who departed this life on October 26, 2003, as shown by the certified copy <br />of the death certificate attached hereto as Exhibit "A° and by this reference <br />incorporated herein. <br />2. That on the date of death, the affiant and decedent were the sole owners <br />as joint tenants with rights of survivorship of that real estate located in Hall <br />County, and legally described as follows: <br />Lot Five (5) and the Northerly One -Half (N1/2) of Lot Seven <br />(7), Block Fourteen (14), in University Place, an Addition to <br />the City of Grand Island, Hall County, Nebraska. <br />3. That by virtue of the survivorship of affiant, affiant became the sole owner <br />of the above - described property. <br />4. That there is no Nebraska Inheritance Tax lien by reason of Nebraska <br />Revised Statutes § 77 -2003 (Reissue 1996) and there is no Nebraska <br />estate tax lien by reason of Nebraska Revised Statutes § 77 -2101 <br />(Reissue 1996). <br />5. That the gross estate of decedent was less than that amount exempt from <br />federal estate taxes. <br />FURTHER AFFIANT SAYETH NOT. <br />Dated this day of )42&'z,r_4 , 200J.5 <br />Diane L. Clatterbuck <br />SUBSCRIBED AND SWORN to before me on ��C� �a��`6 ..cam <br />Notary Pub c <br />DOCS/610373.1 GENERAL NOYARY Safe of Nebraska <br />STACEY A. <br />'RU <br />- My Comm. E9 May 10,200 <br />