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<br /> :t'tJ~~ 10 Q~ <br /> ~~ ~. '\ m <br /> " m '" <br /> ~~,~ ~ C 0:1: m <br /> Z r-..:. <br /> ") ~ c".::::> <br /> <~~<: ~~ <=;> O.(f) o~ <br /> 1t)'K ~ ~ 1: ;tJ ~, c"c::, 0--1 <br />N " $ c: l> <br />S ',~ ."'\ en Z--I N:D <br />S ~ % ~<~ z -oj f11 m <br />c:o I~~~ -<0 00 <br />S ~ N o .." a~ <br />S " N ""z <br />W ~ ~r COz <br />CO ~~~ :t: f11 <br />N ~ ft'\ ::0 l> CD OW <br /> C) ::3 r ::0 a~ <br /> ~) ~, r> <br /> I--> (f) <br /> ~ (/) I--> ;;><; w3:: <br /> l> m <br /> , ~ l"\.) -- co~ <br /> " C> U> <br /> ~ ~ AFFIDAVIT OF MARITAL STATUS (,f) NZ <br /> 0 <br /> 0;:, <br /> 't'\ <br /> STATE OF NEBRASKA ) <br /> ) SS. \0'\J--- <br /> COUNTY OF BUFFALO ) <br /> 0 <br /> The undersigned Affiant, being first duly sworn, upon oath deposes and says: <br /> <br /> <br /> <br />A. On the date of the death of Floyd Frank Bachkora, also know as Floyd F. <br />Bachkora, namely November 19, 2008, Vera A. Bachkora was the <br />surviving spouse of Floyd Frank Bachkora, deceased. <br /> <br />B. A certified copy of the Death Certificate for said Decedent is attached <br />hereto and incorporated herein by reference. <br /> <br />C. Title to the following property was held by the decedent and Affiant as <br />joint tenants and is passed from said decedent to Vera A. Bachkora as <br />said decedent's surviving spouse as provided in Neb. Rev. Stat. Sections <br />77-2004, and Section 77-2102 (1984 Cum. Supp.) to-wit: <br /> <br />TRACT 1 : <br /> <br />The South Half of the Southwest Quarter of the Northwest <br />Quarter of Section Twenty-Two (22), Township Eleven (11) <br />North, Range Twelve (12) West of the 6th P.M., Hall County, <br />Nebraska. <br /> <br />AND <br /> <br />TRACT 2: <br /> <br />The North Half of the Southwest Quarter of Section <br />Twenty-Two (22), Township Eleven (11) North, Range <br />Twelve (12) West of the 6th P.M., Hall County, Nebraska; <br /> <br />D. There is no Federal Estate Tax, Nebraska Inheritance Tax or Nebraska <br />Estate Tax due. <br />