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$� Dates this..•.... day o ::. ia. Dated wis..le fh. ..aay off......, ....,a. eY�'�
<br />On tha "above date, before me•,.tt!Y.%a�:.G.:..'
<br />Oa the above date, before me.. .... d' u& d
<br />a General Not ��'uriq duly" cpgim on�ed and, qualified; a General Notary Public duly, com�st�edj� � ,,y ! 17 ' personally came�...,1.... personally came.:. G�!� Y fib_ v� %�,!
<br />;e` .1
<br />tome known to be the identical person.... whose name to met known to be the tg8ti V
<br />c : affixed to, the foregoi ig instrument: ap grantor . and affii�ed to the fpreg g ,
<br />acknowledged the same to be a voluntary act and deed. acknowledged the samg to $ v." aact�n,•.
<br />WITNESS my hand and Notarial Seal the day, and year WITNESS mY hand aial�TPtarita., Y{ i
<br />last aboye written, last above written. ` ''� .ti (L'� �v`• `'
<br />=-. •�,ii -,�G , �' €`,: ",h ��yt11t:1111O Y71
<br />Notary Notary i/'(Y "T- �. y:..�...;.
<br />My commission expires the =. day of '.: .......... 19 .. A 1 My commi``ss``ion expire& the �'
<br />STATE Oil....�lR'.
<br />STATE OF .............. .. ti 1�.. f • x.,�....A.; a ,
<br />So
<br />..County ; .A �. ....,.. ri...1:..Count a w
<br />PLEASI?i PRINT ALL NAVIES `
<br />Exact'and full name of QWNER, as same appears of record .... Y.. 1. h e., /v d f !1 f ....................... ..................
<br />rr s G t 4 r 3 u u� Book. �'. page...'
<br />age S3 6 ,
<br />If married, full name of spouse ./ / ..., .... ... .................................. ' •l
<br />It unmarried, show single, widower, widow' ...., 1•..
<br />Tax Status.......... ........ _ ....... ... . ..Insurance Co. . _ ...........
<br />` o Amount t _
<br />If mortgage or other liens, show names of holders, amounts, dates and book page of record J F : !d �t !! /7s .. ,A,3;
<br />Glc %Ards GYAAA.•:F5. 3i'3�...N�lar.• ��,�G %,�!1 ..- !•/ �f��9,ol e...3'.?3 St
<br />�.. '
<br />3...�:3....s �CJ �v %ism <a°m -ta .ltcw/ �G�atc^�,�j,r4otu/ � ...
<br />.. ...................... ... _....................... , -.
<br />If an estate, give the names of all the heirs, with the sharetof each. Show names of spouses of tho'
<br />e,marrie�.. /1/d,n, e.
<br />` ............... .... _...... ................... ..•., . _....... ........... , _ ., ..
<br />...................•,.. ................... `�.................. ...•.� �•• ,..........
<br />Name of a 1"/` h e' ...... ....... o .... Page4.
<br />Bok :.
<br />If an of the owners or heirs are
<br />for or administratoF
<br />minors, give their names' and. ages `..1✓........................... ...... . t •
<br />y x � _..,_ .e
<br />...... ............................... . ........... " .......
<br />Name o! guardian .... r' :............... - .. ... ....... ...................... .:. ................ ..... .�.
<br />Rent Agreement- Owner- Tenant (name and address) ... /Y t.f/ ........a. �.n.a/ t} r a.. � >l
<br />{ ..............................
<br />.......... • .......... ..... _. .... .............................
<br />................. ....... _.._........................... .... ............ ........ ........ .....: Y:....:.,................ ............:............:....,
<br />Land$ .................................. Posted ............................................................
<br />Improvements ..... ... ... Payment #
<br />Personal Property ................:. . $............................ Final Payment . $ �� ... . ��52. ::. $:...,../�. ................ ..
<br />................. •.Damages :.•............... $.............. ... Contract No.
<br />Total_• ... .......... ............................... $.......... , s i L
<br />Agent.. !? ,
<br />f �Q%1k�� PiYah�.tStln�JN��!..
<br />State of Nebraska) ss 550
<br />County of hall
<br />Entered on Numerical Index and filed
<br />for record in Gff:ce of. Register of
<br />Deeds on the __...2$tll__.. day of
<br />F�bru�ary_nn'19__lat_8 ------
<br />I o'clock an ^3 . _3Y 7 _. m'Odtes ` S A�.IVI.
<br />ard' recorded in Book of
<br />._174 :Sc� _. a/t�pago�� 5�0��• .� i��Y _ .r � �� �° �•j�''�
<br />Register o Deeds - r .111: -' 1 `4
<br />g .p.11u•
<br />• Y -- Deputy- 3 �.
<br />Fees $ 3.25
<br />
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