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<br />AFFIDAVIT <br /> <br />STATE OF NEBRASKA) <br />)ss. <br />COUNTY OF HALL ) <br /> <br />88-105177 <br /> <br />Affiant, Chris E. Paulsen, after being duly sworn upon <br />oath, does depose and state as follows: <br /> <br />1, That Affiant is the surviving spouse of Donna J. <br />Paulsen, who departed this life on July 10, 1988, as shown by <br />the certified copy of the death certificate attached hereto <br />as Exhibit "A" and by this reference incorporated herein; that <br />Affiant and the said Donna J. Paulsen were husband and wife on <br />the date of Decedent's death on July 10, 1988. <br /> <br />2. That on the date of death, the Affiant and Decedent <br />were the sole owners as joint tenants with rights of survivorship <br />of that real estate located at 917 W. Charles Street, Grand Island, <br />Nebraska, and legally described as follows: <br /> <br />A. The following described real property in Hall <br />County, Nebraska: The Westerly Twenty-two <br />(22) feet of Lot Three (3), and the Easterly <br />Twenty-two (22) feet of Lot Four (4), in Block <br />"A", of Boehm's Subdivision, in the City of <br />Grand Island, Nebraska, subject to any easements <br />and restrictions of record, and <br /> <br />B. The following described real property in Hall <br />County, Nebraska: The Westerly Forty-four (44) <br />feet of the Southerly Forty-two (42) feet of <br />Lot Four (4), in Block "A", in Boehm's Subdivision <br />in the City of Grand Island, Nebraska. <br /> <br />Also a right of way for a driveway over and upon <br />the Four (4) feet adjacent to the Easterly line <br />of the property described above, and subject to <br />a right of way heretofore granted over and upon <br />the Easterly Four (4) feet of the herein conveyed <br />tract. It being understood that the easements <br />granted and reserved are for the joint use and <br />benefit of the tract adjacent thereto. <br /> <br />3. That by virtue of the survivorship of Affiant, Affiant <br />became the sole owner of the above-described property. <br /> <br />4. That this Affidavit is given as evidence that pursuant <br />to R.R.S., 1943, Section 77-2003, no inheritance tax lien arising <br />due to the death of Decedent can attach to the above-described <br />real estate and that pursuant to R,R,S. Section 77-2012, no <br />Nebraska est~te tax lien arising due to the death of Decedent <br />can attach to the above-described property. <br /> <br />FURTHER AFFIANT SAYETH NOT. <br />Dated: $'~~,..z. 't /'1J'f; <br /> <br />~~,c:::p~ <br />CHRIS E. PAULSEN, Affiant <br />Subscribed and sworn to before me this..6~l~i day Of_r~v <br /> <br />1988. <br /> <br />~~v5/~ <br /> <br />Notary Public <br /> <br />1&....--1 <br />..':'&.':'r- <br />