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<br /> tJ :110 () n <br /> ~J~ j ~ :It: )::. <br /> C in (,<':' .-...., <br /> n Mi' <::::::> o Vi CJfTl <br /> Z <;;;:;;) <br /> n .'J.'.' ! o -j ~Rr <br /> -cv i:. ...... c;r.> <br /> :J: ~ C ~~ c::l> <br /> ~, (\: ~ ',.., %-1 <br /> t\\i m . ! ,..,.., o[ <br />N n c:c ~m <br />S 3 :;lIlI; :I: -<0 <br />s 8'-, ~.....z I I C') <;:: ?- ~ 0" ~G;- <br />en . ! o~ <br />s ""', r:) r) --n I-' "z <br />--" 0,;, t) ;;, cli r; ::I: rr. - <br />.f:>. 0 )> [rJ ~I <br />'-" rtl ::n <br />-.....J I fTl 3 ,::0 <br />--" -t 0 r ):> <br /> Cf) (f) <br /> c.o ::><: <br /> :t>> <br /> c...:> --- <br /> 0') (J) ...... .... <br /> en Z <br /> 0 <br /> <br /> <br /> <br />AFFIDAVIT OF MARITAL STATUS <br /> <br />5T A TE OF NEBRASKA ) <br />) ss. <br />COUNTY OF HALL ) <br /> <br />COMES NOW, the undersigned, being first duly sworn upon oath, and <br />deposes and states that the undersigned knows the Decedent and the surviving <br />spouse of the Decedent and that the following information is true and correct. <br /> <br />1. Name of Decedent: Marvin M. Hartmann <br />Date of Death: April 4, 2005 <br />Domicile at Death: Grand Island. Hall County, Nebraska <br />Name of Surviving Spouse: Elaine Hartmann <br />Date of Marriage: April 2, 1950 <br /> <br />2. The Affiant is the daughter of the Decedent and, in that capacity, is <br />familiar with the marital status and the death of the Decedent. <br /> <br />3. That there is no federal estate tax, Nebraska inheritance tax or <br />Nebraska estate tax due. <br /> <br />4. Title to the following described real estate is held by the Decedent and <br />the surviving spouse in joint tenancy, to-wit: <br /> <br />Lot 35, Western Heights Third Subdivision, City of Grand Island, <br />Hall County, Nebraska. <br /> <br />5. As of the date of death, the real estate had a fair market value of <br />$126,563.00. <br /> <br />6. The Decedent and the surviving spouse were married as of the date of <br />death. There is no Nebraska inheritance tax lien by reason of Nebraska Revised <br />Statute 977-2003. There is no Nebraska estate tax lien by reason of Nebraska <br />Revised Statute 977-2102. <br /> <br />FURTHER Affiant saith net. <br /> <br />12cmda Wh~_____u_ <br />-~----~"._--- ---- ....... -~-,'-""~ <br />Ronda Wiegert <br /> <br />Subscribed and sworn to before me this /(,!'day of ~~.. <br />2006. <br /> <br />GENElW-HOTARYoSla\llof:n- d', il, ~ <br />K. A. GQOS _ ---------!1--'uu------ ------ - <br />MyComm.&\l.MlY1, Notary Public <br /> <br />