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STATE OF NEBRASKA ) <br />) ss. <br />COUNTY OF HALL ) <br />85- 003777 <br />AFFIDAVIT OF DEATH <br />OF JOINT TENANT <br />ANNA FRANDSEN, being first duly sworn on her oath, de- <br />poses and says that she resides at 525 Memorial Drive, Grand <br />Island, Hall County, Nebraska; that her husband, Frederick P. <br />Frandsen died July 29, 1985, in Grand Island, Hale County, <br />Nebraska; that a copy of his Certificate of Death is attached <br />hereto as Exhibit "A "; that her husband left no property sepa- <br />rately owned by him and that all property subject to consideration <br />and computation for determination of any Nebraska Inheritance Tax <br />and Federal Estate Tax was property owned by the decedent in <br />joint tenancy with your Affiant, his surviving spouse; that the <br />total value of all such property as of July 29, 1985, valued <br />at its fair market value on that date, did not equal or approach <br />the sum of $400,000; that Affiant is entitled to an exemption in <br />computation of both Nebraska Inheritance Tax and Federal Estate <br />Tax of the total value of all such taxable property received by <br />her by reason of the death of the decedent or otherwise, and <br />that there is no Nebraska Inheritance Tax nor Federal Estate <br />Tax due or owing by this Affiant by reason of property passing <br />to her upon the death of Frederick P. Frandsen on July 29, 1985. <br />Real estate owned by the parties in joint tenancy is <br />described as follows: <br />Lot Three (3), Block Four (4), Meves <br />First Addition to the City of Grand <br />Island, Hall County, Nebraska. <br />ANNA FRANDSEN, Af iant <br />Subscribed and sworn to before me a Notary Public this <br />day of August, 1985. <br />ammor a- aM.rr.rwm Notary Public <br />DUANE A. BUNG <br />U <br />