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�^ <br />�� <br />� <br />� <br />N � <br />� �r. <br />�� <br />� �� <br />�� <br />(�D � <br />C�)"I � <br />��. <br />■III�� <br />�� <br />I��w <br />�� <br />�b <br />� �1 �� <br />Q � "' I <br />�� � � <br />W <br />b�� <br />� <br />� <br />� <br />� <br />N <br />� � -- <br />�� m <br />� � � <br />� � <br />� � � <br />� �� <br />-� <br />I � � <br />m <br />� <br />n <br />� <br />-� . <br />STATE OF NEBRASKA <br />COUNTY OF HALL <br />) <br />) ss <br />) <br />� <br />�1'! <br />� <br />� <br />� n � <br />��� <br />�' � . <br />_ � <br />n � <br />� � <br />� <br />�� <br />� r� . <br />I'*1 <br />�-� _ <br />o �� <br />� �G <br />rT; <br />rw7 <br />c7 <br />� <br />� <br />� <br />� � <br />4.7 —�.{ <br />q � � <br />� _...{ <br />� � �7 <br />C:J <br />� <br />� <br />►--► <br />GJ <br />q <br />0 <br />Q '� <br />- , - t � <br />� rn <br />D [z.r <br />r-- � <br />F'� �,. <br />�� <br />�. <br />�. <br />u � <br />� <br />&+� <br />� <br />� <br />� <br />� <br />G7 <br />Q <br />c,o <br />� <br />6� <br />�' �d <br />SUCCESSION TO REAL PROPERTY <br />BY AFFIDAVIT FOR SMALL ESTATE � I� �� <br />(30-24,129) <br />The undersigned Affiant, upon being first duly sworn, deposes and states: <br />1. Ernest Chamberlin died June 15, 2006 at 54 years of age and a <br />resident of Douglas County, Nebraska. Ernest Chamberlin died owning an <br />undivided interest in the following described real estate in Hall County, Nebraska: <br />Lot 35 and Lot 36 in the West Lawn Additian, an addition ta the City <br />of Grand Island, Hall County, Nebraska, �xcept the northerly 16 <br />feet of the east 46 feet af Lot 35, and the east 46 feet of Lot 36 <br />heretafore deeded by Harriet L. Gouge ta Edna Evers by deed <br />dated January 17, 1944. <br />2. The value of the decedent's interest in all real praperty in th� <br />dec�dent's probate estate lacated in this state does not exceed $25,Op0.00 and <br />his total nan-probate estate is less than $130,OOO.pO. <br />3. Thirty days have elapsed since the death of th� decedent as shawn in <br />a certified copy of the decedent's death certificate attached to this Affidavit. <br />4. No application or petitian for the appointment of a Personal <br />Representative is pending or has been granted in any jurisdictian. <br />5. The undersigned, as claiming successor, is entitled to the real property <br />by reason of the joint tenancy relationship that existed between the decedent, <br />Ernest Chamberlin, and his father, Melvin D. Chamberlin. Melvin D. Chamberlin <br />is now deceased and the undersigned is the Beneficiary of the real estate by <br />reason of being subsequently named by Melvin D. Chamberlin as surviving joint <br />tenant an the property in the place af Ernest Chamberlin. <br />6. The undersigned, as claiming successor, has made an investigatian <br />and has been unable ta determine any Will of the decedent. No ather persvn <br />has a right to the interest of th�: decedent in the described properky. <br />7. The undersigned, as claiming successar, is the brother of the decedent <br />and the son af Melvin D. Chamberlin, who died on April 24, 2010 as a joint t�nant <br />with the undersigned on the above real estate by deed doc. no. ZOQ608179. <br />Edwin Chamb�rlin, under aath, states that all statements in this Affidavit <br />are true and material and further acknowledges that any false statement made by <br />him may subject him to penalties relating to perjury under Section 2$-915 of <br />Revised Statutes of Nebraska. <br />��_ � r <br />Edwin Chamberlin <br />19D8 W. 1 St Street <br />Grand Island, NE 688Q1 <br />Subscribed and sworn to befare me the � <br />Chamberlin. <br />GENEW►t, NOTARY - 5tate of Nepraska <br />C]UANE A. BUftNS <br />PREPAf2ED BY: �Y C�. �A. ��� 28, 2U12 <br />Duane A. Burns, #10534 <br />MAYER, BURNS, KOENIG & JANULEWICZ <br />308 North Locust Street, Suite 306 <br />P. O. Box 2300 <br />Grand Island, NE 68802 <br />(3A8) 384-1120 <br />day of October, 2010, by Edwin <br />�C�� <br />Notary Public �� <br />