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<br />STATE OF NEBRASKA
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<br /> AFFIDAVIT ~:::T- 0 (j) ...J::Z
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<br />COUNTY OF HALL
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<br />J'I_ffiant, ANNA SCHUMACHER, after being first duly sworn on
<br />oath, deposes and states as follows:
<br />1. That Affiant is the surviving spouse of Gene Thomas
<br />Schumacher, who died January 12, 2006, as shown by the certified
<br />copy of the Decedent's death certificate attached hereto as
<br />Exhibit "A" and by this reference incorporated herein; that
<br />Exhibit "A" is a certified copy of the original Certificate of
<br />Death on file with the Bureau of Vital Statistics, Department of
<br />Health, State of Nebraska.
<br />2. That Affiant and the said Decedent were husband and wife
<br />on the date of the Decedent's death on January 12, 2006, and were
<br />on said date the sole owners as j oint tenants not tenants in
<br />common, of the real estate legally described as follows:
<br />LOT 12 IN ROSS & ASHTON PARK SUBDIVISION IN THE CITY
<br />OF GRAND ISLAND, HALL COUNTY, NEBRASKA
<br />3. That by reason of the provisions of the Joint Tenancy
<br />Warranty Deed, Affiant became the sole owner of the above
<br />described property on Decedent's death.
<br />4. That this Affidavit is given as evidence that pursuant to
<br />Neb.Rev.Stat. Section 77-2003, no inheritance tax lien arising due
<br />to the death of the Decedent can attach to the above described
<br />real estate and that pursuant to Neb.Rev.Stat. Section 77-2012, no
<br />Nebraska estate tax lien arising due to the death of the Decedent
<br />can attach to the above described property.
<br />FURTHER AFFIANT SAITH NOT.
<br />DATED: February c:?fL., 2006.
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<br />[11"2.11/(' //Jdt"-i//~ /~t'/7L<
<br />ANNA SCHUMACHER, Affian
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<br />SUBSCRIBED in my
<br />day of February, 2006.
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<br />PREPARED BY:
<br />John M. Cunningham, #17276
<br />CUNNINGHAM, BLACKBURN, FRANCIS,
<br />BROCK & CUNNINGHAM, Attorneys
<br />222 North Cedar Street
<br />P. O. Box 2280
<br />Grand Island, NE 68802
<br />(308) 384-2636
<br />
<br />GENERAL NOTARY. StaIB of Nebraska
<br />JOHN M. CUNNINGHAM
<br />My Camm. Exp. Nov. 22, 2007
<br />
<br />CO,
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