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AFFIDAVIT <br />STATE OF NEBRASKA ) <br />) ss: <br />COUNTY OF HALL ) <br />CASH <br />CHECK J-t ) <br />REFUNDS: <br />CASH <br />CHECK__ <br />RECO DED <br />HALL L'. ."'1TY NE <br />5 u nib APiTi 13 2 21 13 <br />C;',E1,.-I,.i' L_i': l)I 4..+'l-EUS <br />COMES NOW the undersigned, being duly sworn, deposes and says that the following <br />information is true and correct: <br />1. Name of Decedent: Blanca Alicia Hernandez <br />Date of Death: 03/17/2026. <br />2. The Affiant is related to the Decedent as follows: daughter. <br />3. Title to the real estate, as set forth below, is held by the Decedent and the affiant in <br />joint tenancy: <br />Lot Eight (8), in Block Seven (7), Bonnie Brae Addition to the City of Grand Island, Hall <br />County, Nebraska. <br />4. The Decedent's name on the death certificate is shown as Blanca Alicia Hernandez, <br />which was her maiden name, but on the deed was shown as Blanca A. Mendoza, which was her <br />married name. Blanca Alicia Hernandez and Blanca A. Mendoza are one and the same person. <br />Ana V. Molina, Affiant <br />SUBSCRIBED AND SWORN to before me this 13th day of April, 2026. <br />GENERAL. NOTARY - State of Nebraska <br />MARY J. LIVINGSTON <br />My Comm. Exp. June 5, 2027 <br />