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r,.: ~ ~- ~~ 9v ~ ,'~~ 6,b'~ c:a ~ _.,~~ ~~ ~ cam' f---~ ~ e ~ ~ D ~ ~ ~ O rn ~ ~ rry C'~ C,P] CD ~~ ~ ~ ~ ~ ~ C~] ~ ~ ~ O v~ F--+ r` Can Crl x CD C ~ ~' ~ ~' ~ ~ v --- AFFIDAVIT FOR TRANSFER OF REAL PROPERTY WITHOUT PROBATE UNDER THE NEBRASKA PROBATE CODE lo~s~ S-TATS Cr NEBRASKA ) ss: COUNTY OF HALLL ) Affiant, JAMES MARTIN PETERSEN, after being first duly sworn on oath, deposes and states as follows: 1. That Affiant is the surviving spouse of Betty Gretchen Petersen, who died July 29, 2010, as shown by the certified copy of the Decedent's death certificate attached hereto as Exhibit "A" and by this reference incorporated herein; that Exhibit "A" is a certified copy of the original Certificate of Death on file with the Bureau of Vital Statistics, Department of Health, State of Nebraska. 2. That Affiant and the said Decedent were husband and wife on the date of the Decedent's death on July 29, 2010, and were, on said date, the sale owners as joint tenants, not tenants in cum~mon, of the real estate legally described as follows: LOT THIRTEEN (13), WESTERN HEIGHTS THIRD TO THE CITY OF GRAND ISLAND, HALL COUNTY, NEBRASKA 3. That by reasan of the provisions of the Joint Tenancy Warranty Deed, Affiant became the sole owner of the above described property on Decedent's death. 4. That this Affidavit is given as evidence that pursuant to Neb.Rev.Stat. Section 77-2003, no inheritance tax lien arising due to the death of the Decedent can attach to the above described real estate and that pursuant to Neb.Rev.Stat. Section 77--2012, no Nebraska estate tax lien arising due to the death of the Decedent can attach to the above described property. FURTHER AFF ANT SAITH NOT. ;SAT E D: !/S Z~ 2 it I U. TI ~ E SUBSCRIBED IN MY PRESENCE and sw r to bef re me MES MARTIN PETERSEN, this Z~ day of ~ y.~20 GENERAL NOTARY -~~ ub ' C JOHN M. C M My Comm. Exp, Nov 22, Ot 1