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<br />N <br />S <br />S <br />OJ <br />IS> <br />W <br />CJ'1 <br />-.....j <br />..... <br /> <br />'\~ <br />~~ ~ <br />\; '" <br />~~~ <br />~, ~ <br />~ N ~ <br />'" '" 3:" <br />~~~ <br />~~~ <br />~ <br />6:\ <br />~ <br />~ <br />f'l <br /> <br /> 10 n E <br /> m ifi ~ <br /> 2:! j"'.......:t <br /> ~~ c:> (J> 0 <br /> n ::z: C:J. 0-1 ni <br /> Z co <br /> n ;;l'l\ .......,'. I c::~ N <br /> % ~ C r"':"" :D ::z-1 :0 <br /> m ~ :x: ~\..: -0 -\f'1 0 ~ <br /> n (II rn ...... :;::;:0 -<0 <br /> ~ :c "..., ~,'.'- N a"'" 0 )> <br /> o ''-'~ CI> <br />t CD ""Tl ~:-: CO Z <br /> .." t ::r: P1 <br /> , Cl en <br /> ~ 0 1> 0) <br />t rn :::0 I' :::0 -I <br /> ,.,.., ::3 r 1> W :0 <br /> 0 (f) c: <br /> (f) ........ U1 s:: <br /> ........ 7" m <br /> );0- ~ ~ <br /> Ul '-'" .,---, <br /> C) (f) t-Io Z <br /> U'iI'"!! <br /> (f) 0 <br /> AFFIDAVIT <br /> <br />STATE OF NEBRASKA <br /> <br />ss: <br /> <br />COUNTY OF HALL <br /> <br />/cJ,So <br /> <br />Affiant, FRANCIS W. GIDMOND, after being first duly sworn on <br />oath, deposes and states as follows: <br />1. That Affiant is the surviving spouse of Pearl Gidmond, <br />who died April 7, 2008, as shown by the certified copy of the <br />Decedent's death certificate attached hereto as Exhibit "A" and by <br /> <br />this reference <br />certified copy <br />the Bureau of <br />Nebraska. <br />2. That Affiant and the said Decedent were husband and wife <br /> <br />incorporated herein; that Exhibit <br />of the original Certificate of Death on <br />vi tal Statistics, Department of Health, <br /> <br />"A" is a <br /> <br />file with <br /> <br />State of <br /> <br />on the date of the Decedent's death on April 7, 2008, and were, on <br />said date, the sole owners as j oint tenants, not tenants in <br />common, of the real estate legally described as follows: <br /> <br />LOT ONE (1) IN BLOCK ONE (1), WEST BEL AIR <br />ADDITION, CITY OF GRAND ISLAND, HALL COUNTY, <br />NEBRASKA <br /> <br />3. That by reason of the provisions of the Joint Tenancy <br />Warranty Deed, Affiant became the sole owner of the above <br />described property on Decedent's death. <br />4. That this Affidavit is given as evidence that pursuant to <br />Neb.Rev.Stat. Section 77-2003, no inheritance tax lien arising due <br />to the death of the Decedent can attach to the above described <br />real estate and that pursuant to Neb.Rev.Stat. Section' 77-2012, no <br />Nebraska estate tax lien arising due to the death of the Decedent <br />can attach to the above described property. <br />FURTHER AFFIANT SAITH NOT. <br />DATED, ~ :A L.-I , <br /> <br />2008. <br /> <br />~ I\V M~ <br />FRANCIS W. GIDMOND <br /> <br /> <br />SUBSCRIBED IN MY PRESENCE a <br />W. GIDMOND, this :z.. V-day of <br /> <br />me by FRANCIS <br /> <br />J;GENERAL NOTARY 4 State of HlJlllaska <br />8. J..CUNNJNGHAM <br />MyComm. Exp. Aug.17, 200t <br />