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BEFORE ME, the undersigned authority, personally appeared Kara Jarzynka, Personal Representative of <br />the Estate of Timothy Jarzynka, who, being first duly sworn, deposes and says that: <br />1. The undersigned owns the following described property: <br />Lot One (1), Stearley Subdivision, Hall County, Nebraska, according to the recorded plat thereof. <br />( "Property ") <br />and <br />2. The undersigned is the owner of a certain manufactured housing unit located on said land. <br />3. The undersigned states that a Certificate of Title was not issued for said manufactured housing <br />unit. <br />4. The manufactured housing unit is on a permanent foundation on the Property with its w eel <br />removed and is connected to gas, electricity and water utilities provided by 5� R -� u <br />/ � / ,4 '4 ro:0 <br />5. The undersigned agrees to indemnify fully and hold harmless Prairie Title, Inc., and its <br />underwriting company from any loss which either might sustain as a result of any of the foregoing <br />representations being untrue. Such indemnification shall include, but shall not be limited to, all costs and <br />expenses, including attorneys fees, arising from defending against, negotiating, compromising, settling or <br />paying in full any claims against the Property. <br />STATE OF NEBRASKA <br />COUNTY OF <br />)ss. <br />212 ). <br />The foregoing instrument was acknowledged before me this A0411 day of .34 rLL4 , 2013, by <br />Kara Jarzynka, Personal Representative for the Estate of Timothy Jarzynka. <br />GENERA. NOTARY - State of Nebra*a <br />VICT ORIA f. ROEDER <br />*Comm Epp. Dec. 22, 2014 <br />MANUFACTURED HOUSING AFFIDAVIT <br />PR <br />Kara Jarz a, P sonal Representative <br />for the Es e of imothy Jarzynka <br />Notary Public <br />201303158 <br />