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<br />~ ;lQ () () <br /> Q1 :c: )> <br />C\}~ c: m UI <br /> () :r <br />~\~~ no z ~ <br />0 l <br />~~, ~> (I) <br />1\ " ~ 0(1) <br />f)\~t:;: ~::c l~ <br /> ,_ <br />"1:; () C; f <br />c., <br />C> <br />,J <br /> <br /> ~ <br /> ~ <br /> c:::::> <br /> ~ c::no <br /> -r1 <br />~ ~~ ,....., <br />co <br />C') c{- f-'o <br />C> " . <br />..." (fl <br />:- , <br />c' , <br />f'-I [ ::D <br />I'T1 ::3 <br />0 <br />Ul ~ <br /> CJ <br /> N <br /> ~ <br /> <br />I\.) <br />is <br />is <br />(J) <br />G) <br />-->. <br />W <br />-->. <br />(J) <br /> <br />200GOJ~16 <br /> <br />AFFIDAVIT OF MARITAL STATUS <br /> <br />STATE OF NEBRASKA <br /> <br />ss. <br /> <br />COUNTY OF HALL <br /> <br />0 (n 0 'f;1 <br />0 -j <br />c ):> N fit <br />:z -i ~ <br />-i Pl C) <br />-< c <br />l...::':''} ~'T~ CJ .it <br /> .......::-w (]') <br />.....-in r'T: - <br />J> co ~.~ <br />r- ;:0 <br />r- )> <br /> (fl <br /> ;:;0:;: ~~ <br /> ):> <br />-........ <br />(fl 0) ..... <br />(f) '2 <br /> 0, <br /> <br />COMES NOW, the undersigned, being first duly sworn upon oath, <br />and deposes and states that the undersigned knows the Decedent and <br />the surviving spouse of the Decedent and that the following <br />information is true and correct. <br /> <br />1. Name of Decedent: F. William Hotz <br />Date of Death: July 6, 2004 <br />Domicile at Death: Grand Island, Hall County, Nebraska <br />Name of Surviving Spouse: Wilma o. Hotz <br />Date of Marriage: September 4, 1947 <br /> <br />2. The Affiant is the son of the Decedent and, in that <br />capacity, is familiar with the marital status and the death of the <br />Decedent. <br /> <br />3. That there is no federal estate tax, Nebraska inheritance <br />tax or Nebraska estate tax due. <br /> <br />4. Title to the following described real estate is held by <br />the Decedent and the surviving spouse in joint tenancy, to-wit: <br /> <br />Lot Twelve (12), Block Two (2), Pleasant View Addition to <br />the City of Grand Island, Hall County, Nebraska. <br /> <br />5. As of the date of death, the real estate had a fair market <br />value of $92,750.00. <br /> <br />6. The Decedent and the surviving spouse were married as of <br />the date of death. There is no Nebraska inheritance tax lien by <br />reason of Nebraska Revised Statute ~77-2003. There is no Nebraska <br />estate tax lien by reason of Nebraska Revised Statute ~77-2102. <br /> <br />FURTHER Affiant saith not. <br /> <br />d;1~ U~~ ~ 4 <br />Frederick William Hotz, Jr. i/I I tI/ <br /> <br />Subscribed and sworn to before me this ~ day of February, <br />2006. <br /> <br /> <br />GENERAL NOTARY - State 01 Nllblaska <br />DEN1SED y . 5 <br />My Comm. Exp. tv !,o <br />