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200904780 <br />2Q � 5 <br />AFFIDAVIT FOR SUCCESSION <br />TO REAL PROPERTY WITHOUT PROBATE <br />STATE OF NEBRASKA ] <br />[ ss: <br />COUNTY OF HALL ] <br />The undersigned affiant, upon being first duly sworn, does hereby depose and <br />state: <br />1. The value of the real property owned by Harold W. Fothergill, deceased, <br />does not exceed $5,000. The legal description of the real estate owned by decedent is <br />as follows: <br />Lot One (1), Ross Heights Subdivision, Hall County, <br />Nebraska excepting a tract more particularly described <br />in Report of Appraisers recorded as Document No. 87- 101014 <br />2. The valuation of the real estate described above is $138,077 as shown on <br />the Hall County Assessor's records on June 1, 2009. The current mortgage debt <br />against the real estate is $150,254.01. The Decedent's interest in the real estate has a <br />negative value. <br />3. Thirty days have elapsed since the death of the Decedent. Harold W. <br />Fothergill died on May 9, 2009 (see attached Death Certificate). <br />4. No application or petition for the appointment of a Personal <br />Representative is pending or has been granted in any jurisdiction. <br />5. The undersigned Affiant, Elizabeth M. Fothergill, formerly Elizabeth M. <br />Krejci, widow of Harold W. Fothergill, is entitled to the above described real property <br />because Harold W. Fothergill died intestate and the undersigned is entitled to the first <br />$50,000.00 of his estate. <br />