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= <br />� <br />� <br />0 ��� <br />� � <br />0 �_ <br />� --- <br />� - <br />�� <br />� <br />�� <br />��� <br />� <br />.� <br />5� � <br />ao� � <br />��r <br />Z- o `� t� <br />� ,� Z Z <br />� � � C <br />r <br />� °� � <br />Z � <br />� � <br />� r <br />M � <br />� <br />�o <br />0 <br />� <br />� <br />� <br />� <br />� <br />4 <br />� <br />C <br />��� <br />� .T. • <br />� <br />� � � <br />x � � <br />_ � � � � rn <br />� = o "� o <br />� o � <br />m � � Z <br />� S P"�"I <br />in � D� o0 <br />A 3 r �' <br />r m� <br />o � � <br />� � p � <br />� � ...R..,1 <br />� f13 � <br />� � <br />AFFIDAVTT OF MARITAL STATUS <br />) <br />) ss. <br />) <br />� � <br />� � <br />0 : � <br />� � <br />F-� �„ <br />C�- � <br />-�. <br />� <br />� � <br />� <br />�011U744� <br />STATE OF NEBRASKA <br />COUNTY OF HALL <br />COMES NOW, the undersigned, being duly sworn, deposes and says that the undersigned is the <br />surviving spouse of the Decedent and that the following information is true and correct: <br />1. Name of Decedent: Ethel E. Heider <br />Date of Death: July 3, 2011 <br />Domicile at Date of Death: Hall County, Nebraska <br />Name of Surviving Spouse: Elmer A. Heider <br />Date of Marriage: August 12, 1953 <br />2. The Affiant is related to the Decedent as follows: surviving spouse. <br />3. There is no Federal Estate Tax, Nebraska Inheritance Tax or Nebraska Estate Tax that is due because <br />of Decedent's death. <br />4. Title to the following described real estate is held by the Decedent and the surviving spouse of the <br />Decedent in joint tenancy, to-wit: <br />A tract of land comprising the north One Hundred Eight Nine and Six <br />Hundredths (189.06) feet of the North One Half of the Southwest Quarter <br />(Nl/2SW 1/4) of Section Twenty-Six (26), Township Eleven (11) North, Range <br />Nine (9) West of the 6th P.M., in Hall County, Nebraska, comprising 11.496 <br />acres, more or less, <br />5. As of the date of death, the real estate has a fair market value of $161,729.00 <br />6. The Decedent and �ant were married as of date of death. There is no Nebraska Inheritance Tax <br />lien by reason of Nebraska Revised Statutes Section 77-2003. There is no Nebraska estate tax lien by reason <br />ofNebraska Revised Statutes Section 77-2102. <br />FLTRTI�R AFFIANT SAITH NOT. <br />SUBSCRIBED and SWORN to be <br />������ 1 <br />` ���� M- <br />� {1� � JIp W �� � <br />�� <br />�..�� � ,�-'�'� <br />E er A. Heider <br />