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88- 104320 STATE OF NEBRASKA 55. AFFIDAVIT OF DEATH OF JOINT TENANT COUNTY OF HALL ROBERT H. BEBERNISS, being first duly sworn upon his oath, deposes and says that he resides at 1018 South Vine Street, Grand Island, Hall County, Nebraska; that his wife, ADELIA BEBERNISS, a/k/a Delia Beberniss, died July 26, 1988, at the age of 88 years in Grand Island, Hall County, Nebraska; that a copy of her Certificate of Death is attached hereto as Exhibit "A"; that his wife left no property separately owned by her, and that all property subject to consideration and computation for determination of any Nebraska Inheritance Tax and Federal Estate Tax was property owned by the Decedent in joint tenancy with your Affiant, her surviving spouse; that the total value of all such property as of July 26, 1988, valued at its fair market value on that date, did not equal or approach the sum of $600,000; that Affiant is entitled to an exemption in computation of either Nebraska Inheritance Tax and Federal Estate Tax of the total value of all such taxable property received by him by reason of the death of the Decedent or otherwise, and that there is no Nebraska Inheritance Tax nor Federal Estate Tax due or owing by this Affiant by reason of the property passing to him upon the death of Adelia Beberniss on July 26, 1988. Real estate owned by the parties in joint tenancy is described as follows: A. Lot Twenty-Three (23), Buenavista SubdiviSion, an Addition to the City of Grand Island, Hall County, Nebraska; and, B. The Southwest Quarter of the Southwest Quarter (swlswl) of Section Fifteen (15), Township Ten (10) North, Range Ten (10), West of the 6th P.M., Hall County, Nebraska. .w.~{)-) V3Ju?~ ROBERT H. BEBERNISS SUBSCRIBED AND SWORN to before me, a Notary Public, this ~ day of August, 1988. .J:-............ IIUANIA._ .............. ~C7~/ Notary Public