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<br />~` <br />~ <br />~ <br />~~ <br />~ ~ <br />~ a <br />B <br />~ <br />~~ <br />~` <br />~ .,~ ~y <br /> <br />~ ° R1 <br />~ -~.~ <br />~ o <br />~ <br />~ <br />~~ . <br />~ <br /> <br />.~~ ~ <br />°~ <br />_ _ _... ~' <br /> <br />STATE OF NEBRASKA ) <br />)ss. <br />COUNTY OF HALL ) <br />AFFIDAVIT OF MARITAL STATUS <br />AND FURTHER AFFIANT SAITH NOT. <br />Eugene L. Pletcher <br /> r~ <br /> <br /> ~ ~ ~ ~ Z <br />~ ~ ~~ ~ ~ <br /> °' ~ ~ ~ m <br />~, • v <br /> w ~, -.T, ~, <br /> ~ ~~ ~ ~ <br /> r7-, <br /> <br /> ~ ~~ <br /> <br />r ~ <br />w-• ~ <br /> c~ © ~ <br /> ~ <br /> c ~ ~~ ~+ m <br /> ~ -.a z <br /> z <br /> 0 <br />COMES NOW, the undersigned, being duly sworn, deposes and states that the <br />undersigned is the surviving spouse of the Decedent, and that the following information is true <br />and correct: <br />~ n <br />T <br /> <br />~ <br /> Z <br />~ ~ <br /> <br />n ~ C/! <br /> <br />x = O,. <br /> <br /> Q <br />Name of Decedent: Ilene J Pletcher. <br />Date of Death: November $, 2009 <br />Domicile at Date of Death: Hall County, Nebraska <br />Date of Marriage: June 4, 1963 <br />2. The Affiant is the surviving spouse of the decedent. <br />There is no Federal Estate Tax, Nebraska Inheritance Tax or Nebraska Estate Tax <br />that arose, or can arise, by virtue of the Decedent's death. <br />4. Title to the following described real estate was held in joint tenancy by the <br />Decedent and Eugene L. Pletcher, the Decedent's spouse, on the date of the <br />Decedent's death, toTwit: <br />Lot Seven (7), Block Two (2), Stewart Place Subdivision, in the City of <br />Grand Island, Hall County, Nebraska. <br />Together with all buildings, fixtures, improvements and appurtenances belonging <br />to such premises. <br />S. As of the date of death, the real estate has a fair market value of $97,732.00. <br />Plc-FcJ.~er <br />6. The Decedent and Eugene L. f~Fwere married as of the date of death of <br />Ilene J. Pletcher. There is no Nebraska Inheritance Tax lien, and no Nebraska <br />Inheritance Tax Lien. <br />Subscribed and sworn to before me this 16 o ru • , 2010. _ <br />estate. Pletcher. Ilene <br />Affidavit of Marital Status <br />04- I 1 fi3 <br />GENERAL NOTARY -State of Nebraska <br />~A~N e. STEHI_l1C Notary Public <br />My Comm. Exp. May 1, 2010 <br />