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[Cneck applicable box(es)] 2 0 0 0 0 0 210 <br /> ❑ Adjustable Rate Rider ❑ Condominium Rider ❑ 1-4 Family Rider <br /> ❑ Graduated Payment Rider ❑ Planned Unit Development Rider ❑ Biweekly Payment Rider <br /> Q Balloon Rider ❑ Rate Improvement Rider ❑ Second Home Rider <br /> ❑ Other(s) [Specify] <br /> BY SIGNING BELOW, Borrower accepts and agrees to the terms and covenants contained in this Security Instrument and in any <br /> rider(s) executed by Borrower and recorded with it. <br /> Witnesses: <br /> . <br /> (Seal) <br /> Bo«oWe� R ER R. HARRIE <br /> /�i � • (Seaq <br /> ffOWe� JpLENE K. HARRIE <br /> (Seal) <br /> eo«o W a� <br /> (Seal) <br /> eo«oWa� <br /> [Space Below This Line For Acknowledgment� <br /> STATE OF NEBRASKA <br /> � ss: <br /> COUNTY OF HALL <br /> I, , a Notary Public in and for said county and state, do hereby <br /> certify that ROGER R. HARRIE AND JOLENE K. HARRIE HUSBAND AND WIFE <br /> personally appeared before me and is (are) known to me to be the person(s) who, being informed of the contents of the foregoing <br /> instrument, have executed same, and acknowledged said instrument to be their , free and voluntary act and deed <br /> and that thev executed said instrument for the purposes an���uses t�e�r�ein set forth. <br /> �ne, Sne, fnay) <br /> Witness my hand and official seal this 23rd day of December , 1999 . <br /> My Commission Expires: �, i ___� <br /> G�:.::;',L E;OTARY-State of�:.�res�ca <br /> CUFiIE R.MiNCER <br /> ��P.?y Ccmr��Er,p.May 25,2�02 SEAL <br /> This instrument was prepared by: <br /> Form 3028 9/90 <br /> F1029.LMo (10/99) Page 5 ot 5 <br />