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Written consent for release of lien and cancellation of Certificate of Title from each lien holder must be attached to this <br />Affidavit. This completed Affidavit must be presented to the County Treasurer along with the Certificate of Title in the <br />county where the real property is located for cancellation of the existing Certificate of Title to occur. <br />A filing fee is required per §33 -109 and §33 -112. <br />Mobile Home Owner #1 <br />Name MirhaPl J. Frei 1inp r <br />19978 Ostrich Dr <br />Address <br />City, State Zip Lebanon , MO 65536 <br />Real Estate Owner #1 <br />® Owner of real estate <br />Affidavit of Affixture <br />For a Mobile Home With a <br />Nebraska Certificate of Title <br />Mobile Home Owner #2 <br />Name Lori L. Freilinger <br />Address <br />City, State Zip <br />Attach additional Affidavit(s) if more than 2 owners. <br />19978 Ostrich Dr <br />Real Estate Owner #2 <br />Lebanon, 1`4O 65536 <br />❑ Leasing real estate <br />Mobile Home Description: Year 1996 <br />Vehicle Identification Number F8201842 <br />Make <br />Four Scaconc <br />Model Mf pd I - Tome <br />Title Number <br />If two Vehicle Identification Numbers are present, an Affidavit must be completed for each number. <br />Name Name <br />Address Address <br />City, State, Zip City, State, Zip <br />Attach additional Affidavit(s) if more than 2 entities are to be notified. <br />O <br />N <br />Copy of Notice of Cancellation shall be provided to all owners listed above and the following financial institution(s): <br />Name <br />Address <br />City, State, Zip <br />Attach additional Affidavit(s) if more than 2 entities are to be notified <br />Name <br />Address <br />City, State, Zip <br />1 of 3 <br />Affidavit of Affixture For a Mobile Home With a Nebraska Certificate of Title 7/2012 <br />c <br />z <br />0 <br />39C9- <br />