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L r 87-- 106829 STATE OF NEBRASKA ) SS. COUNTY OF HALL ) AFFIDAVIT OF DEATH OF JOINT TENANT DOVIE P. OLESON, being first duly sworn on her oath, deposes and says that she resides at 815 South Claussen Avenue, Grand Island, /� Hall County, Nebraska; that her husband, Roy L. Oleson died 9y&uST 3'�Q, M97 in Grand Island, Hall County, Nebraska; that a copy of his Certificate of Death is attached hereto as Exhibit "A "; that her husband left no property separately owned by him and that all property subject to consideration and computation for determination of any Nebraska Inheritance Tax and Federal Estate Tax was property owned by the Decedent in joint tenancy with your Affiant, his surviving spouse; that the total value of all such property as of UGVS7` �o<C 1rf8 % , valued at its fair market value on that date, did co not equal or approach the sum of $ lP ©o' ®no. that Affiant is entitled to an exemption in computation of either Nebraska Inheritance Tax and Federal Estate Tax of the total value of all such taxable property received by her by the reason of the death of the Decedent or otherwise, and that there is no Nebraska Inheritance Tax nor Federal Estate Tax due or owing by this Affiant by reason of property , 9passing to her upon the death of I�pj/ ,C.. OLcScA/ on uUu5t- 3,eD .r15FE7 Real estate owned by the parties in joint tenancy is described as follows: Lot Five (5) in Block Two (2), Claussen Country View Addition to the City of Grand Island, Hall County, Nebraska. I� F � _zI-, -z- DOVIE P. OLESON SUBSCRIBED AND SWORN to before me, a Notary Public, this day of November, 1987. Notary Public F-1;