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Mobile Home Owner #1 <br />Name Erin Romans <br />Address 4444 S 60TH RD <br />City, state zip GRAND ISLAND, NE 6880 <br />Affidavit of Affixture <br />For a Mobile Home With a <br />Nebraska Certificate of Title <br />Name <br />Address <br />1 of 3 <br />Affidavit of Afhxtme Fora Mobile Home With a Nebraska Certificate of title <br />Mobile Home Owner #2 <br />Traci Romans <br />Attach additional Affidavit(s) if more than 2 owners <br />® Owner of real estate ❑ Leasing real estate <br />T <br />N <br />0) <br />Written consent for release of lien and cancellation of Certificate of Iitle from each lien holder must be attached to this <br />Affidavit. This completed Affidavit must be presented to the County Ireasurer 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 />4444 S 60TH RD <br />City state zip GRAND ISLAND NE,68803 <br />Mobile Home Description: Yea/ 2003 MakePATRIOT HOME, INC. ModelVA�1 <br />Vehicle Identification Number CV3668AB I N Title Number ' ;].3 ( i <br />If two Vehicle Identification Numbers are present, an Affidavit must be completed for each number. <br />Real Estate Owner #1 <br />Name Erin Romans <br />Address 4444 S 60TH RD <br />City, State, Zip GRAND ISLAND, NE 68803 <br />Attach additional Affidavits) if more than 2 entities are to be notified. <br />Real Estate Owner #2 <br />Name Traci Romans <br />Address4444 S fi()TH RD <br />City, State, zip GRAND ISLAND. NE 68803 <br />Copy of Notice of Cancellation shalt be provided to all owners listed above and the following financial institution(s): <br />NameAMANDA BUCHANAN/SHEILA MOYNIHAN FIRST AMERICAN MORTGAGE SERVICE: <br />Address <br />1100 Superior Ave, Suite 200 <br />City, State, Zip Cleveland, OH 44114 <br />N/A <br />Attach additional Affidavit(s) if more than 2 entities are to be notified <br />Name <br />Address <br />City, State, Zip <br />7/2012 <br />