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<br /> <br /> <br /> ~ ~ r~r <br /> In ~ - <br /> IV +wrwrr- O t'f z 7C o <br /> w A 00 W <br /> X. _ S m <br /> ITI <br /> (D M d Gxa r- v>i co C <br /> C`? 1T1 <br /> Cn <br /> ~R 17 <br /> W cn, <br /> AFFIDAVIT OF MARITAL. STATUS <br /> STATE OF NEBRASKA ) <br /> ) ss. 0 <br /> COUNTY OF HALL ) /l n <br /> <br /> COMES NOW, the undersigned, being first duly sworn upon oath, and deposes and <br /> states that the undersigned knows the Decedent and the surviving spouse of the Decedent <br /> and that the following information is true and correct. <br /> <br /> 1. Name of Decedent: Frances E. Allison <br /> Date of Death: November 25, 2009 <br /> Domicile at Death: Cairo, Hall County, Nebraska <br /> Name of Surviving Spouse: Robert D. Allison <br /> Date of Marriage: October 16, 1976 <br /> 2. The Affiant is the daughter of the Decedent and, in that capacity, is familiar with <br /> the marital status and the death of the Decedent. <br /> 3. That there is no federal estate tax, or Nebraska inheritance tax due. <br /> <br /> 4. Title to the following described real estate is held by the Decedent and the <br /> surviving spouse in joint tenancy, to-wit: <br /> Lot Ten (10), and a part of Lot Eleven (11), in fractional Block One (1), <br /> Parkhill Subdivision, an Addition to the City of Grand Island, Hall County, <br /> Nebraska, more particularly described as follows: Beginning at the <br /> Northwest corner of said Lot Eleven (11), thence running Easterly along the <br /> north line of Lot Eleven (11), a distance of Nine (9) feet; thence running <br /> southerly a distance of One Hundred Forty -six and Three Tenths (146.3) <br /> feet to a point on the south line of Lot Eleven (11); thence Southwesterly <br /> along the south line of Lot Eleven (11), a distance of Two and Three Tenths <br /> (2.3) feet; thence Westerly along and south line of Lot Eleven (11) a <br /> distance of Fourteen and Seven Tenths (14.7) feet to the Southwest corner <br /> of Lot Eleven (11); thence North along the West line of Lot Eleven (11), a <br /> distance of One Hundred Forth one (141.0) feet to the point of beginning. <br /> 5. As of the date of death, the real estate had a fair market value of $104,944.00. <br /> 6. The Decedent and the surviving spouse were married as of the date of death. <br /> There is no Nebraska inheritance tax lien by reason of Nebraska Revised Statute 77- <br /> 2003. There is no Nebraska estate tax lien by reason of Nebraska Revised Statute 177- <br /> 2102. <br /> FURTHER Affiant saith not. <br /> <br /> <br /> Debara Smith <br /> <br /> Subscribed and sworn to before me this 2010. <br /> <br /> <br /> 1u~ p111111WIR94p <br /> Notary Pu <br /> prb hsy q <br /> ppy <br /> 1~: "'11I <br />