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<br />N <br />o <br />s <br />CO <br />o <br />...... <br />...... <br />o <br />...... <br /> <br />~~~ <br />~~ C\ <br /><~~ <br />c::> c;-, l::.:" <br />~~ <br />\-\ -< <br />ki~~ <br />~ 1J ~., <br />t>~~ <br />:s: ~ <br />~ <br />~, <br />?\'l <br />t,~ <br />~ <br />lJ.JSL; <br />~l <br />0;:, <br /> <br /> i n ~ <br /> :r ":> <br /> m ~:;~ 0 <br /> 4'~ Vl <br /> Z n :J: :::>l.., CQ 0 -i <br />" ~ c: l>- <br />'% ~ C :1:) :::-. '" ......, Z --j <br />m ~ fT1 <:i., f"T"'l -i jr'J <br />'. OJ <br />n ~ c-) {_ -< c; <br />~ X " ~ <br /> C) . 0 " <br /> '1 -.J ...,., <br /> r z <br /> CJ -'- n'} <br /> fT1 ::0 l>- CO <br /> rr1 <br /> C) 0 :3 r ::D <br /> (f) r > <br /> ~ (j) <br /> I--' ^ <br /> l> <br /> a '--" '---' <br /> OJ (f) <br /> (f) <br /> <br />AFFIDAVIT FOR TRANSFER OF REAL PROPERTY <br />WITHOUT PROBATE UNDER THE NEBRASKA PROBATE CODE <br /> <br />0 ~ <br />N <br />a :0 <br />a r:g <br />CD l; <br />c:> I <br />~ <br />....... <br />C> <br />....... ~ <br /> z <br /> 0 <br />-. <br /><:::J \S........ <br /> 0 <br /> <br />Affiant, JOAN KIRKPATRICK, after being first duly sworn on <br />oath, deposes and states as follows: <br /> <br />STATE OF NEBRASKA <br /> <br />ss: <br /> <br />COUNTY OF HALL <br /> <br />1. That Affiant is the surviving spouse of EUGENE E. <br />KIRKPATRICK, who died on January 10, 2009, as shown by the certified <br />copy of the certified Decedent's death certificate attached hereto <br />as Exhibit "A" and by this reference incorporated herein; that <br />Exhibit "A" is a certified copy of the original Certificate of Death <br />on file with the Bureau of Vital Statistics, Department of Health, <br />State of Nebraska. <br /> <br />2. That Affiant and sqid Decedent were husband and wife on the <br />date of the Decedent's death on January 10, 2009, and were, on said <br />date, the owners as joint tenants, not tenants in common, with <br />rights of survivorship, of the real estate legally described as <br />follows: <br /> <br />LOT ONE (1) IN GRAND ISLAND INDUSTRIAL PARK WEST <br />SUBDIVISION FORMERLY DESCRIBED AS LOT FOUR (4) <br />IN HAYMAN'S SUBDIVISION OF THE WEST HALF OF THE <br />NORTHWEST QUARTER (W1/2 NW1/4) OF SECTION TWENTY <br />FIVE (25), TOWNSHIP ELEVEN (11) NORTH, RANGE <br />TEN ( 10) WEST OF THE 6TH P. M., HALL COUNTY, <br />NEBRASKA <br /> <br />3. That by reason of the provisions of said Joint Tenancy <br />Warranty Deed, Affiant became the sole owner of the above described <br />property on Decedent's death. <br /> <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 real <br />estate and further that pursuant to Neb.Rev.Stat. Section 77-2012, <br />no other tax lien arising due to the death of the Decedent can <br />attach to the above described property and further that personal <br />property owned by Affiant and Decedent as joint tenants passed to <br />Affiant as survivor without any inheritance tax lien arising. <br /> <br />FURTHER AFFIANT SAITH NOT. <br /> <br />~~ <br />DATED:. 'II <br /> <br />2009. <br /> <br />~ I(~~/ <br />-t::7-d-t/L- /-A/' ~ <br />" OAN KIR ATRI K <br /> <br />SUBSCRIBED IN M1v ~RESENCE~d <br />KIRKPATRICK, this /I-'--Oay of v-eA, <br /> <br /> <br />me by JOAN <br /> <br />.j;GENEJW. NOTARY . State of NIbl'uka <br />8. J. CUNMIfOlAII <br />My Comm. &po _11._ <br /> <br />/' <br /> <br />L- <br />