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Return To: Heritage Bank <br />PO Box 5138, 1333 N Webb Road <br />Grand Island, NE 68802 <br />Designation of Homestead - Disclaimer -NE <br />VMP® Bankers SystemsTM <br />Wolters Kluwer Financial Services ® 1987, 2011 <br />C cn <br />o <br />7 1-. c" zr <br />o , ry 11 <br />-n z <br />(.1 <br />r* i /:n <br />3 r <br />t) N <br />m <br /><n <br />State of Nebraska Space Above This Line For Recording Data <br />DISCLAIMER OF RIGHT TO DESIGNATE HOMESTEAD <br />Each of the undersigned states as follows: <br />Non Homestead <br />® I intend to grant a security interest in real property legally described on the attached mortgage <br />or deed of trust. No part of my homestead is presently situated on said real estate, nor will any of <br />my homestead be situated on said property in the future. However, if I establish a homestead on <br />any part of said real estate during the time the mortgage or deed 4or trus"" ,geixa} ,m ti ied and <br />is a lien upon the real estate, I will have no right to make a designation of horestead in ie vent <br />of a foreclosure or trustee's sale upon such mortgage or deed c f Est. ' " b <br />Homestead <br />❑ I intend to grant a security interest in real property legally described on the attached mortgage <br />or deed of trust. My homestead is located on said real estate, and I understand I have the right to <br />make a designation of homestead in the mortgage or deed of trust. If 1 waive or disclaim the right <br />to designate my homestead I am waiving rights, that I would otherwise have, to retain my <br />homestead in the event of default upon such mortgage or deed of trust. 1 hereby waive and <br />disclaim the right to designate my homestead. <br />I have read the paragraph checked above, and I understand the contents of that paragraph. <br />VMPC3291NE) (1107).00 <br />DRDH- LAZ-NE 7/1/2011 <br />Page 1 of 2 <br />CO <br />