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l\.) s S Q:l S 0') Q:l Q:l 0J ~ 't-; ~ ~ G CL\ ~~ ~~ \--l >< ~ [' ^ <: r--' .R..> ~ :.'t:. ~~ <:0.-..0':::. C>I:$~ ~ ~ ~ :"\l ~ 'P Xt (") ~ m ::I: ." c: ~'fl U'l n z () ::c: 7J: ~ t:~ ~ m ~~) n (.1) :x :x: r....~ t:,:::-~~) ("") (f) "'.':::::;) m ~z, C<:J 0 -1 C) Z c > :Q '::, \. ::n :z: _oj r'0 -I Pl ~\. C~ --1 rn rn c.,---;; ::a ~, ~--" -< 0 C) 111 o '~"f l-' 0 -" C) I.::J ''''Tl I-> -., ..-y ).> c' tt ::r rq CO cr.l n-) {\ ',' -0 p.- ('0 C) Z p') ::3 r- ;;0 U) e;-J ~ r' P- O) -l (Jl f--' (f) :;:(J ~ f"0 ^ CD c: l> "'"'::.:Ii Q) ~.!I f---' ----- ----- rn CD (f) W 2: (f) -f Z 0 AFFIDAVIT STATE OF NEBRASKA ss: COUNTY OF HALL COMES NOW the Affiant, Cr~RLES GLEN McCLURE a/k/a CHARLES G. McCLURE and C. G. McCLURE, being first duly sworn on oath, deposes and states as follows: 1. That Affiant is the surviving spouse of LEOTA P. MCCL~7E, r A f'.l4 1_.f?p6 A e J"f/-.... rJ-h ( ..I it t: who died July 19, 2008, as shown by the certitJ..ed copy of the Decedent's death certificate attached hereto as Exhibit "A" and by incorporated herein; that Exhibit "A" is a of the original Certificate of Death on file with Vital Statistics, Department of Health, State of this reference certified copy the Bureau of Nebraska. 2. That Affiant and said Decedent were husband and wife on the date of the Decedent I s death on July 19, 2008, and were on said date the sole owners as joint tenants not tenants in common, of the real estate legally described as follows: LOT ONE (1), BLOCK TWENTY FOUR (24), BAKER'S ADDITION TO THE CITY OF GRAND ISLAND, HALL COUNTy, NEBRASKA 3. That by reason of the provisions of the Joint Tenancy Warranty Deed, Affiant became the sole owner of the above described property on Decedent's death. 4. That this Affidavit is given as evidence that pursuant to Neb.Rev.Stat. Section 77-2003, no inheritance tax lien arises due to the death of the Decedent or can any lien attach to the above described real estate; that pursuant to Neb.Rev.Stat. Section 77- 2012, no Nebraska estate tax lien arising due to the death of the Decedent can attach to the above described property. , "~)t> FURTHER AFFIANT SAITH NOT. Dated: August ~ ,2008. }~ tkJ.?, AI"IL 0;'1 J rjlt-fM-.! CHARLES GLEN McCLURE a/k a CHARLES G. McCLURE and C. G. McCLURE, Affiant h,- SUBSCRIBED in my presence day of August, 2008. 8' PREPARED BY: B. J. Cunnningham, #10865 CUNNINGHAM, BLACKBURN, FRANCIS, BROCK & CUNNINGHAM, Attorneys P. O. Box 2280 Grand Island, NE 68802 (308) 384-2636 XERAL NOTARY. state of NublI$ka , 8. J. CUNNINGHAM , '. My Comm. &po Aug. 11, 2009