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.�� <br />� <br />A�w� <br />N ,� <br />@ �� <br />,_a. � <br />� � <br />� <br />W <br />�^ <br />� <br />.�.� <br />�� <br />�� <br />STATE OF NEBRASKA <br />COUNTY OF ADAMS <br />�7 h �4 r�.- <br />� m N �.;.' c� �� <br />c.� <br />C1 z IT� �� �` — � '' <br />= n D ".r, �a �^ r-�"� � 1"T'1 <br />171 � .�. rrl � � <br />f'1 V1 �,� �_.. "'� �� <br />/� = T' �.,�- � � �7 <br />r ' <br />�:.� ��;� x r i <br />�„ � , � x �M, <br />r r xj <br />C7 �-- � <br />v> � � � <br />� �� <br />� � <br />� <br />AFFIDAVIT <br />) <br />) ss. <br />) <br />PATRICIA A. ORCUTT, being first duly swarn on oath, deposes and says that <br />LYLE L. ORCUTT, Deceased, died on September 14, 2010, at Hastings, County of <br />Adams, State of Nebraska, and at the time of his death, he was married to PATRICIA <br />A. ORCUTT. <br />At the time af his death, he and his spouse, PATRICIA A. ORCUTT, were the <br />owners of record of the fallawing real estate, to-wit: <br />Lats One (1) and Two (2), Amick Acres Fourth Subdivision, Hall County, <br />Nebraska. <br />SEIL�R & PARKER, <br />r.c., �.�.o. <br />LAW OFFICES <br />726 EAST S[DE BI,VA. <br />P.O. BOX 1288 <br />HASTINGS, NE 68902 <br />(402)463-3125 <br />They owned all of their real and personal praperty as joint tenants or in a joint <br />trust, and PATRICIA A. ORCUTT, as the surviving jaint tenant and beneficiary, is now <br />in possession of said property. That as a result of this joint ownership, there is no <br />Federal Estate Tax, State Estate Tax tate Inheritance Tax due. <br />�.� � � � <br />PATRICIA A. ORCUTT, Affiant <br />128 Manument Rd. <br />Doniphan, NE 68832 <br />(4Q2) 845-6210 <br />SUBSCRIBED AND SWORN TO BEF'ORE ME this _� day of <br />n�, S<< , 2010. <br />GENERAL NOTARY - State nf Nebraska <br />III� MAT7H�W D. BAACK <br />�:_ .. .�., ....... My Cnmm. Exp. Jan. 9, 2013 <br />�,/� J�`.�,r: r�,l� <br />Notary Public <br />� <br />� <br />0 <br />� <br />C4) <br />z ` <br />� <br />� <br />c <br />� <br />� <br />7 <br />� <br />z <br />0 <br />/! � � <br />