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$i- 103'274 <br />STATE OF NEBRASKA ) <br />ss. AFFIDAVIT OF DEATH OF JOINT TENANT <br />COUNTY OF HALL ) <br />HELEN G. PHILLIPS, being first duly sworn on her oath, <br />deposes and says that she resides at 1836 West 12th Street, <br />Grand Island, Hall County, Nebraska; that her husband, Victor <br />Phillips, died September 20, 1984, in Grand Island, Hall County, <br />Nebraska; that a copy of his Certificate of Death is attached <br />hereto as Exhibit "A "; that her husband left no property sep- <br />arately owned by him and that all property subject to consid- <br />eration and computation for determination of any Nebraska In- <br />heritance Tax and Federal Estate Tax was property owned by <br />the Decedent in joint tenancy with your Affiant, his surviv- <br />ing spouse; that the total value of all such property as of <br />September 20, 1984, valued at its fair market value on that <br />date, did ;xot equal or approach the sum of $325,000.00; that <br />Affiant is entitled to an exemption in computation of both <br />Nebraska Inheritance Tax and Federal Estate Tax of the total <br />value of all such taxable property received by her by reason <br />of the death of the Decedent or otherwise; and that there is <br />no Nebraska Inheritance Tax nor Federal Estate Tax due or <br />owing by this Affiant by reason of property passing to her <br />upon the death of Victor Phillips on September 20, 1984. <br />Real estate owned by the parties in joint tenancy is <br />described as follows: <br />Lot Nine (9), in Block One (1), in Boggs & <br />Hill's Addition to the City of Grand Island, <br />Hall County, Nebraska. <br />HELEN G. PHIL IP <br />SUBSCRIBED and SWORN to before me, a Notary Public, this <br />-_ day of June, 1987. My commission expires: <br />� <br />OraFaF <br />ML 21L M Notary Public <br />a <br />f <br />r` <br />