Laserfiche WebLink
<br />200709483 <br /> <br />AFFIDAVIT OF MARITAL STATUS <br /> <br />STATE OF NEBRASKA ) <br />) ss. <br />COUNTY OF HALL ) <br /> <br />COMES NOW, the undersigned, being first duly sworn upon oath, and deposes and <br />states that the undersigned knows the Decedent and the surviving spouse of the Decedent <br />and that the following information is true and correct. <br /> <br />1. Name of Decedent: Florence Virginia Jarzynka <br />Date of Death: May 5,2007 <br />Domicile at Death: North Platte, Lincoln County, Nebraska <br />Name of Surviving Spouse: Charles L. Jarzynka <br />Date of Marriage: July 16, 1951 <br /> <br />2. The Affiant is the nephew of the Decedent and, in that capacity, is familiar with <br />the marital status and the death of the Decedent. <br /> <br />3. That there is no federal estate tax, Nebraska inheritance tax or Nebraska estate <br />tax due. <br /> <br />4. Title to the following described real estate is held by the Decedent and the <br />surviving spouse in joint tenancy, to-wit: <br /> <br />The North Half of the South Half of the Northeast Quarter (N1/2 S1I2 NE1/4) <br />of Section Twenty Eight (28), Township Twelve (12) North, Range Eleven <br />(11), West of the 6th P.M., Hall County, Nebraska. <br /> <br />5. As of the date of death, the real estate had a fair market value of $124,000.00. <br /> <br />6. The Decedent and the surviving spouse were married as of the date of death. <br />There is no Nebraska inheritance tax lien by reason of Nebraska Revised Statute '377- <br />2003. There is no Nebraska estate tax lien by reason of Nebraska Revised Statute '377- <br />2102. <br /> <br />FURTHER Affiant saith not. <br /> <br />~(JJJ,jdd (()~-A~ <br />Randall EclWard JarZYrlka~ <br /> <br />Subscribed and sworn to before me this L day of November, 2007. <br />. / <br />'~.'.{;) <br /> <br />Notary Public <br /> <br /> <br /> <br />GENERAL NOTARY. State of Nebraska <br />DENISE D. MYERS <br />My Comm. Exp. Nov. 20, 2010 <br />