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CASH CHECK I/o.o0 N O) 0 cn w 0o 0o HALL INS NB 0 3 8 8 101b REFUNDS: CASH CHECK !HTYNE is 59 `y,D REGISTER OF DEEDS Return to: Colby R. Collins 3548 Schroeder Ave Grand Island, NE 68803 AFFIDAVIT OF MARITAL STATUS WITH DEATH CERTIFICATE Comes Now, the undersigned, being first duly sworn upon oath, deposes and states that the undersigned knows the Decedent and is the surviving spouse of the Decedent and that the following information is true and correct. 1. Name of Decedent: Tommy Ree Collins Date of Death: July 16, 2026 Domicile at Death: Grand Island, Hall County, Nebraska Name of Surviving Spouse: Sonya Jane Collins Date of Marriage: November 26, 1967 2. The Affiant is the spouse of the Decedent and in that capacity is familiar with the marital status and the death of the Decedent. 3. That there is no federal estate tax, Nebraska inheritance tax or Nebraska estate tax due. 4. Title to the following described real estate is held by the Decedent and the surviving spouse in joint tenancy, to wit: Legal Description: Lot Four (4), Country Meadows Second Subdivision, in the City of Grand Island, Hall County, Nebraska (Physical Address: 336 Redwood Road, Grand Island, NE 68803) 5. As of the date of death, the real estate had an assessed value of $304,172. 6. The Decedent and the surviving spouse were married as of the date of death. There is no Nebraska inheritance tax lien by reason of Nebraska Revised Statute § 77-2003. There is no Nebraska estate tax lien by reason of Nebraska Revised Statute §77-2102. FURTHER THIS AFFIANT SAYETH NOT. STATE OF NEBRASKA ) ) ss: COUNTY OF HALL ) r SUBSCRIBED and sworn to before me on this i`Ita'y of Au-5,4A , 2026 by Sanyt Cr6 11 ns , Affiant. PREPARED BY: Colby R. Collins Telephone: (308) 380-2574 3548 Schroeder Ave. Grand Island, NE 68803 Lelz_9( Q Cep Notary Public .ENERIL NOTARY -Slate of Nebraska ECHO A, ALCORN *Cann. Exp. March 21,2030 Page 1 of 1