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<br />O(f) ~f <br />o ---t <br />C::l> <br />z---t <br />~m <br />-<0 <br />0-" o(t <br />I'1z (J) _ <br />::r: nj ~I <br />:Z>a:1 <br />r :::0 <br />r ):> <br />(f) <br />'"' <br />:I> <br />-.... - <br />(j') c.n~ <br />en <br /> /t..>o <br /> <br /> -.::>3 <br /> Vo S( <br /> ~\ ~ ';1Q n ~ <br /> ~~ m % <br /> eX "TI <br /> l1\ t:- c m <br /> () z n x <br /> --- ~.". '" <br /> ~- V\ S ::;: () t:l <br />N ""~<..4 rl1 )). ~ ,......, <br /> <;:;::> <br />is ~w t-, (') c.1) c:....""'3 <br />is ~ <;;;lI':> <br />en l" -1-- '" ::r ~~ <br />is ~ ::3 <br />+:>. tJ\ = <br />en -= <br />0"1 0 f"\) <br />0"1 U1 <br /> -" <br /> 0 r <br /> m :n <br /> 200604655 m ::3 <br /> C? <br /> c.n ......... <br /> 0 <br /> AFFIDAVIT OF MARITAL STATUS ......... <br /> 0 <br /> <br />STATE OF NEBRASKA <br /> <br />ss: <br /> <br />COUNTY OF HALL <br /> <br />COMES NOW the undersigned, being duly sworn, deposes and <br />says that the undersigned is the surviving spouse of the Decedent <br />and that the following information is true and correct: <br />1. Name of Decedent: ROGER A. WILLIAMS <br />Date of Death: June 2, 1995 <br />Domicile at Date of Death: Grand Island, Hall County, <br />Nebraska <br /> <br />Name of Surviving Spouse: Mary E. Williams <br />Date of Marriage: January 30, 1971 <br />2. The Affiant is related to the Decedent as follows: <br />Surviving spouse. <br />3. There is no federal estate tax, Nebraska inheritance tax <br />or Nebraska estate tax due. <br />4. Title to the real estate, as set forth below, is held by <br />the Decedent and the surviving spouse of the Decedent in joint <br />tenancy: <br /> <br />A. Lot Four (4), in Block Two (2), in John W. <br />Lambert's Addition to the City of Grand Island, <br />Hall County, Nebraska; <br /> <br />and <br /> <br />B. The West Half of Lot Two (2), and All of Lot Three <br />(3), in Block Two (2), Lambert's Addition to the <br />City of Grand Island, Hall County, Nebraska. <br />