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Return To: BANK OF DONIPHAN <br />P 0 BOX 270 <br />DONIPHAN, NE 68832-0270 <br />Each of the undersigned states as follows: <br />Non- Homestead <br />Homestead <br />Designation of Homestead- Disclaimer -NE <br />VMP® Bankers SystemsTM <br />Wolters Kluwer Financial Services ® 1987, 2011 <br />2 01308143 <br />State of Nebraska Space Above This Line For Recording Data <br />DISCLAIMER OF RIGHT TO DESIGNATE 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 of trust remains unsatisfied and <br />is a lien upon the real estate, I will have no right to make a designation of homestead in the event <br />of a foreclosure or trustee's sale upon such mortgage or deed of trust. <br />D 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 I 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. I 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 />VMPC329(NE)11107).D0 <br />DRDH- LAZ -NE 7/1/2011 <br />Paige 1 of 2 <br />