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<br />AFFIDAVIT
<br />
<br />STATE OF NEBRASKA
<br />
<br />ss:
<br />
<br />COUNTY OF HALL
<br />
<br />(.:....:.3,
<br />L-'
<br />
<br />Affiant, MARIE DE MARTINEZ, after being first duly sworn on
<br />oath, deposes and states as follows:
<br />1. That Affiant is the surviving spouse of HOMERO MARTINEZ,
<br />who died June 10, 2006, as shown by the certified copy of the
<br />Decedent's death certificate attached hereto as Exhibit "A" and by
<br />
<br />incorporated herein; that Exhibit
<br />of the original Certificate of Death on
<br />Vital Statistics, Department of Health,
<br />
<br />"A" is a
<br />
<br />this reference
<br />certified copy
<br />the Bureau of
<br />Nebraska.
<br />2. That Affiant and the said Decedent were husband and wife
<br />on the date of the Decedent's death on June 10, 2006, and were on
<br />
<br />file with
<br />
<br />State of
<br />
<br />said date the sole owners as joint tenants not tenants in common,
<br />of the real estate legally described as follows:
<br />LOT THREE (3) HIDDEN LAKES SUBDIVISION NUMBER THREE, IN
<br />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 />
<br />FURTHER
<br />Dated:
<br />
<br />AFFIANT S~H NOT.
<br />Augus t , 2006 "'--....
<br />
<br /><:,. --"-.,,,
<br />
<br />
<br />MARIE
<br />
<br />SUBSCRIBED in my presence and
<br />day of August ~, 2006.
<br />
<br />/
<br />
<br />/'., ...,i..,.. .
<br />PREPARED BY: ,,,,0" t,,;; ;,
<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 />6ENERAL NOTARY. State of NC;'fi)s;: l
<br />JOHN M, CUNNi"~.:";" '
<br />. My Comm, Ex". ~'O'I ." ., - ;
<br />- "'" .", J
<br />
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