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<br /> ;lID n ~ <br /> m % <br /> ~ m <br />n z n :I: <br />::z: ~ 0 ;'l; <br />m !-!' <br />n <br />~ :l: <br /> <br /> <br /><;:) <br /> <br /> ~ ~ <br /> =.. Ow <br /> c:::. <br /> '?(" ~ 0--1 0 <br /> C- C l> N ~ <br /> 2::--1 <br />:0 ~' c: --In'! <br />~~-~ r- -<0 0 ~ <br /> 0 "'T1 0 <br />" en " z - <br />0 r fTj -...J ~ <br />f11 -0 l> en c:> <br />f11 :3 r ::0 <br />~ r l> en 3 <br /> en <br /> ~ ;:00:; 0') (1) <br />STATUS l> 0') a <br /> en "-'" ''''"-"' <br /> ...J: ~ W ~ <br /> C4 <br /> <br />'" <br />s <br />S <br />-...J <br />S <br />CJl <br />0) <br />0) <br />w <br /> <br />AFFIDAVIT OF MARITAL <br /> <br />STATE OF NEBRASKA <br /> <br />ss: <br /> <br />COUNTY OF HALL <br /> <br />COMES NOW the undersigned, being dul_y- swornL deposes and <br />says that the'und~rsi~ned is the surviving spouse of the Decedent <br />and that the following information is true and correct: <br /> <br />CJ <br />~ <br /> <br />1. Name of Decedent: Adam R. Sokol <br />Date of Death: April 27, 2000 <br />Domicile at Date of Death: Grand Island, Hall County, <br />Nebraska <br />Name of Surviving Spouse: Carolyn G. Sokol <br />Date of Marriage: February 4, 1936 <br /> <br />2. The Affiant is related to the Decedent as follows: <br />surviving spouse. <br /> <br />3. There is no federal estate tax, Nebraska inheritance tax <br />or Nebraska estate tax due. <br /> <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 />Lot Sixteen (16), Block Five (5), Dill & Huston's <br />Addition to the City of Grand Island, Hall County, <br />Nebraska. <br /> <br />5. As of the date of death, the real estate has a fair <br />market value of: $84,000.00. <br /> <br />6. The Decedent and Affiant were married as of the date of <br />death. There is no Nebraska inheritance tax lien by reason of <br />Nebraska Revised Statutes Section 77-2003. There is no Nebraska <br />estate tax lien by reason of Nebraska Revised Statutes Section <br />77-2102. <br /> <br />7. A certified copy of the Death Certificate of Adam R. <br />Sokol is attached hereto marked Exhibit A and made a part hereof. <br /> <br />Further Affiant saith not. <br /> <br />e~ JI .;?~ <br />CAROLYN . SOKOL, Afflant <br />this ~,~ day of <br />-. ~ <br /> <br />~. ~;~~+-.., <br />Notary u 1 c <br /> <br />~K~__ <br /> <br />SUBSCRIBED AND SWORN to before me <br />2007-~ <br /> <br />EIfW. Nl1lW. 8tIII II Nebraska <br />~o .N...) MARY J. LMNGSTON <br />^..e..-r'-c1 Camnt. .... S. 2011 <br />. REPARE' BY: <br />Mary J. Livingston #16122 <br />Attorney for Carolyn G. Sokol <br />The Yancey, 2nd & Locust <br />P. O. Box 1563 <br />Grand Island, NE 68802 <br />(308) 381-7301 <br />