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m <br /> <br /> <br />~ A <br />a ~ ~ <br />~ --+ c~ <br />~ ~ <br />c n i ~ ~ ~ <br />~ p <br /> -~ , <br />-r r~ <br /> <br /> <br /> <br />~ A <br />~~~ '~" ~ rn ~G <br />W Gn ~ ? <br />C. <br />~^ n ~ <br /> <br />~ <br />~.. AFFIDAVIT OF MARITAL STATUS <br />Comes Now, the undersigned, being first duly sworn upon oath, deposes and states that the ~ <br />v <br />undersigned knows the Decedent and the surviving spouse of the Decedent and that the following <br />information is true and correct. <br />1. Name of Decedent: Heather Lynn Gideon aka Heather Lynn Smith <br />Date of Death: February 27, 2010 <br />p Domicile at Death: 16006 West Wood River Road <br />~"~` Name of Surviving Spouse: Matthew G. Gideon <br />v <br />© Date of Marriage: July 19, 1997 <br />~ 2. The Affiant is the husband of the Decedent and in that capacity is familiar with the <br />a <br />~ marital status and the death of the Decedent. <br />W <br />3. That there is no federal estate tax, Nebraska inheritance tax or Nebraska estate tax <br />due. <br />4. Title to the following described real estate is held by the Decedent and the surviving <br />spouse in joint tenancy, to wit: <br />Lot One (1), M. & H. Gideon Subdivision, Hall County, Nebraska <br />S. As of the date of death, the real estate had a fair market value of $151,735.00 <br />6. The Decedent and the surviving spouse were married as of the date of death. <br />There is na Nebraska inheritance tax lien by reason of Nebraska Revised Statute § <br />77-2003. There is no Nebraska estate tax lien by reason of Nebraska Revised <br />Statute §77-21.02. <br />FURTHER THIS AFFIANT SAYETH NOT. <br />STATE OF NEBRASKA ) <br />ss: <br />COUNTY OF HALL ) <br />e <br />Matthew G. Gideon, Affiant <br />SUBSCRIBED and sworn to before me on this ~ day of Y ~ , 2010, by <br />Matthew G. Gideon, Affiant. <br />~ENERP,;. NOtARY - grate of Nebraska <br />JAMIE MUSS JANKOVITZ <br />My Comm, Exp. May 25, 2010 <br />~~. = ~ tke..~ <br />Notary Public <br />i`~ <br />Jamie Mues Jankovitz # 20754 <br />BRADLEY, ELSBERND, ANDERSEN, <br />KNEALE & MUES JANKOVITZ, P.C. <br />202 West Third Street <br />P.O. Box 639 <br />Grand Island, NE 68802 <br />Telephone: (308) 382-2128 <br />