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V <br />85-.. 006002 <br />STATE OF NEBRASKA ) <br />ss. AFFIDAVIT OF DEATH <br />COUNTY OF HALL ) <br />t: ALLEN R. KNOWLES, being first duly sworn on his oath, <br />deposes and says that his wife, Dorothy M. Knowles, died on the <br />29th day of November, 1985, at St. Francis Hospital in Grand <br />Island, Hall County, Nebraska; that she died testate, but her <br />Will has not been offered for probate. She left no assets <br />separately owned by her. Any assets in which she had an inter- <br />est at the time of her death were owned in joint tenancy with <br />this Affiant, her surviving spouse. The total value of her <br />gross taxable assets for Federal Estate Tax purposes did not <br />exceed $400,000. No Nebraska Inheritance Tax is owing in her <br />estate, and no Federal Estate Tax is owing in her estate. In- <br />eluded among the jointly -owned assets was the following- described <br />real estate: <br />Fractional Lot Seven (7) and all of Lot <br />Eight (8), all in Block Three (3), Gil- <br />bert's Second Addition to the City of <br />Grand Island, Hall County, Nebraska. <br />DATED this 4th day of December, 1985. <br />ALLEN R. KNOWLES <br />SUBSCRIBED and sworn to before me this 4th day of Decem- <br />ber, 1.985. My Notarial Commission expires: 2 -4- <br />M�WMrM�_�rwa�iwY Notary Public <br />AR?HUR Q MATER <br />Mp As 6F fir 4 M <br />U <br />I <br />