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<br />200512619 <br /> <br />AFFIDAVIT FOR TRANSFER <br />OF PERSONAL PROPERTY WITHOUT PROBATE <br />UNDER NEBRASKA PROBATE CODE <br /> <br />State of Nebraska ) <br />) ss: <br />County of Hall ) <br /> <br />The undersigned affiant, upon being duly sworn, does hereby depose and state: <br /> <br />-1:------'he value of the enlire Estaie of -Clarence E. Greenwait. Deceased. wherever located, iess <br /> <br />liens and encumbrances, which are subject to probate proceedings, do not exceed $25,000. <br />2. Thirty (30) days have elapsed since the death of the Decedent. <br /> <br />3. No application or petition for the appointment of a Personal Representative is pending or <br /> <br />has been granted in any jurisdiction. <br /> <br />4. Affiant is entitled to payment and delivery of all property held by others in the sole name of <br /> <br />the Decedent pursuant to Nebraska Probate Code Section 30-24, 125 and the affiant's <br /> <br />entitlement is based upon affiant's status as wife. <br /> <br />5. Pursuant to Nebraska Probate Code Section 30-24,126, the person paying, delivering, <br /> <br />transferring or issuing personal property or the evidence thereof pursuant to this affidavit is <br /> <br />discharged and released to the same extent as if said person dealt with a Personal <br /> <br />Representative of the Decedent; said person is not required to see to the application of the <br /> <br />personal property or evidence thereof or to inquire into the truth of any statement in this affidavit. <br />Dated: I J ~(')'0("5 <br /> <br />'~ LI' <br />~:. ;;<;.,LA..e~ .nz7-' Affiant <br />Name: Dorth reenwalt <br />Address: 1104 W Anna <br />Grand Island, NE 68801 <br />Telephone No. (308) 382-1939 <br /> <br />. r;th <br />Subscribed and sworn to before me on this Ii' day of <br /> <br />eal <br /> <br />GENERAl NOTARY . State of Nebraska <br />TRACI A. RABER <br />My Comm. Exp. July 11, 2009 <br /> <br />", [lV) ('L t l <br />Notary Public <br /> <br />/''-;:.: /' 7 111 h .' '~A_'r) <br />"-....", '-_~ ~ "-, ~.. {A.. .. . <br />.'~- 1 V' <br />-' k--L-.\....\..... <br /> <br /> <br />,-, <br />