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AFFIDAVIT OF MARITAL STATUS <br />STATE OF NEBRASKA <br />) ss. <br />COUNTY OF HALL ) s <br />COMES NOW, the undersigned, being duly sworn, deposes and says that the undersigned is the o <br />surviving spouse of the Decedent and that the following information is true and correct: <br />1. Name of Decedent: Richard A. Benzel. <br />Date of Death: January 6, 2003. <br />Domicile at Date of Death: Hall County, Nebraska <br />Name of Surviving Spouse: Marjorie A. Benzel. <br />Date of Marriage: March 28, 1950. <br />2. The Affiant is the Decedent's surviving spouse. <br />3. There is no Federal Estate Tax, Nebraska Inheritance Tax or Nebraska Estate Tax that is due <br />because of Decedent's death. <br />4. Title to the following described real estate is held by the Decedent and the surviving spouse <br />of the Decedent in joint tenancy, to -wit: <br />LOT FIFTEEN (15) IN BISHOP HEIGHTS SUBDIVISION, GRAND <br />ISLAND, HALL COUNTY, NEBRASKA. <br />5. As of the date of death, the real estate has a fair market value of approximately $105,190.00. <br />6. The Decedent and Affiant were married as of January 6, 2003, the Decedent's date of death. <br />There is no Nebraska Inheritance Tax lien by reason of Nebraska Revised Statutes Section 77 -2003. <br />There is no Nebraska estate tax lien by reason of Nebraska Revised Statutes Section 77 -2102. <br />FURTHER AFFIANT SAITH NOT. <br />m <br />Subscribed and sworn to before me this _ day of Apri 2003. <br />GENERAL NOTARY - State of Nebraska <br />GALEN E. STEHLIK Not blic <br />Comm. Exp. May t, 2006' <br />ifitadmie mm, <br />�o <br />n l'1 <br />T <br />= D <br />:s <br />M CA <br />_ <br />p <br />7C <br />` ' <br />c D <br />iy <br />M <br />N <br />CA <br />fV <br />WO A <br />D <br />�' <br />_ <br />tJ <br />r' <br />fa <br />r� <br />r-- T,. <br />Ul rF <br />cac <br />(D <br />W <br />Cn <br />'� <br />ref• <br />Z <br />200305917 <br />AFFIDAVIT OF MARITAL STATUS <br />STATE OF NEBRASKA <br />) ss. <br />COUNTY OF HALL ) s <br />COMES NOW, the undersigned, being duly sworn, deposes and says that the undersigned is the o <br />surviving spouse of the Decedent and that the following information is true and correct: <br />1. Name of Decedent: Richard A. Benzel. <br />Date of Death: January 6, 2003. <br />Domicile at Date of Death: Hall County, Nebraska <br />Name of Surviving Spouse: Marjorie A. Benzel. <br />Date of Marriage: March 28, 1950. <br />2. The Affiant is the Decedent's surviving spouse. <br />3. There is no Federal Estate Tax, Nebraska Inheritance Tax or Nebraska Estate Tax that is due <br />because of Decedent's death. <br />4. Title to the following described real estate is held by the Decedent and the surviving spouse <br />of the Decedent in joint tenancy, to -wit: <br />LOT FIFTEEN (15) IN BISHOP HEIGHTS SUBDIVISION, GRAND <br />ISLAND, HALL COUNTY, NEBRASKA. <br />5. As of the date of death, the real estate has a fair market value of approximately $105,190.00. <br />6. The Decedent and Affiant were married as of January 6, 2003, the Decedent's date of death. <br />There is no Nebraska Inheritance Tax lien by reason of Nebraska Revised Statutes Section 77 -2003. <br />There is no Nebraska estate tax lien by reason of Nebraska Revised Statutes Section 77 -2102. <br />FURTHER AFFIANT SAITH NOT. <br />m <br />Subscribed and sworn to before me this _ day of Apri 2003. <br />GENERAL NOTARY - State of Nebraska <br />GALEN E. STEHLIK Not blic <br />Comm. Exp. May t, 2006' <br />ifitadmie mm, <br />