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<br />N <br />IS <br />IS <br />-..J <br />IS <br /><D <br />(Xl <br />(Xl <br />N <br /> <br />~D <br />(J) C, IV. A) <br />~ :s \.., <br />l". --I" <br />;-\ ~ v< <br />j' c:.:. ru rf\ <br />s::- r< \ ;s <br />j . Cf < <br />r-l . <br />,_"is ~ <br />~O .;- <br />,-0 -<.:.. <br />:::; nl <br />'" ....... <br />;"-'-" Vl <br /> <br /> 10 I I Q~ <br /> m <br /> "T1 <br /> c::: m en <br />no z n:t: <br />0 ;;:0;; <br />~> I <br />~ , I <br />(")(.1) I I <br />"':I: j <br /> ~ <br /> j <br /> I <br /> <br /> :"'....~ <br /> (::::.,.) Q U) <br /> C:::> <br />"- --.2 0 --l <br />....:l:~ .....~~ c :p <br />"" ::\"- "'- ..... -1 <br />= "'- <br />frl ~lc' c:= -f rq <br />liO) ,..'- --< C__) <br />o":\i:: N 0 "'r, <br />"" \ ...... '"Tf ;~'l.": <br />", <br />o C'l- ::7:' 1':1 <br />P1 lZ\' ..') ::n 1>- en <br />,.,1 , :3 r ~_1:J <br />Q f. r )0>- <br />Vi " f-"> (f) <br />~ ,..... ;?<; <br /> J-... <br /> r0 ---- '--"" <br /> w Q) <br /> u> <br /> <br /> <br />< <br />1'1\ <br />\i'--. <br />~ <br />~ <br />t-J <br />STATE OF NEBRASKA <br /> <br />COUNTY OF HALL <br /> <br />AFFIDAVIT OF MARITAL STATUS <br /> <br />) <br />) ss. <br />) <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 Schweitzer <br />Date of Death: February 16, 1994 <br />Domicile at Death: Cairo, Hall County, Nebraska <br />Name of Surviving Spouse: Harold Schweitzer <br />Date of Marriage: August 26, 1936 <br /> <br />2. The Affiant is the daughter 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 />Lots One (1), Two (2), Three (3) and Four (4), Block Four (4), Fifth Addition <br />to the Village of Cairo, Hall County, Nebraska. <br /> <br />5. As of the date of death, the real estate had a fair market value of $78,292.00. <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 S77- <br />2003. There is no Nebraska estate tax lien by reason of Nebraska Revised Statute S77- <br />2102. <br /> <br />FURTHER Affiant saith not. <br /> <br />-:J V' '-- <br />.......-", '~..I ... " ,:' <br /> <br />R~~~c~;~~;(l ~lT(z~.t-~ <br /> <br /> <br />GEHEilAL NOTARY. State of Neb_ <br />DENISE D. MYERS <br />My Comm. Exp. Nov. 20, 2010 <br /> <br />0 ~ <br />r'V <br />0 3. <br />0 0:- <br />-J - <br />C) ::s <br />(D g <br />Q.) i <br />Q.) <br />r'\J <br /> Z <br /> Q <br /> <br />1;:2'00 <br />