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<br />200708743 <br /> <br />'- <br /> <br />AFFIDA VIT FOR TRANSFER <br />OF PERSONAL PROPERTY WITHOUT PROBATE <br />UNDER NEBRASKA PROBATE CODE <br /> <br />STATE OF NEBRASKA ) <br />)S5. <br />COUNTY OF HALL ) <br /> <br />The undersigned Affiant, upon being first duly sworn, does hereby depose and state: <br /> <br />1. The value of the entire Estate of Douglas Wiley Brockman, Decedent, wherever <br /> <br />located, less liens and encumbrances, which is subject to probate proceedings, does not <br /> <br />exceed $25,000.00 <br /> <br />2. Thirty days have elapsed since the death of the Decedent, as shown on the attached <br /> <br />certified Death Certificate of the Decedent, and marked as Exhibit "A". <br /> <br />3. No Application or Petition for the appointment of a Personal Representative is pending <br /> <br />or has been granted in any jurisdiction. <br /> <br />4. Affiant is entitled to payment and delivery of all property held by others in the sole <br /> <br />name of the Decedent pursuant to Nebraska Probate Code Section 30-24,125 and the <br /> <br />Affiant's entitlement is based upon Affiant's status as the surviving spouse ofthe <br /> <br />Decedent. <br /> <br />5. Pursuant to Nebraska Probate Codc Section 30-24,126, the person paying, delivering, <br /> <br />transferring or issuing personal property or the evidence thereof pursuant to this <br /> <br />Affidavit is discharged and released to the same extent as if said person dealt with a <br /> <br />Personal Representative of the Decedent; said person is not required to see to the <br /> <br />application of the personal property or evidence thereof or to inquire into the truth of <br /> <br />any statement in this Affidavit. <br />