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200001448 <br />LIEN <br />KNOW ALL MEN BY THESE PRESENTS: <br />That Gilbert C. Garcia and Pamela A. Garcia, husband and wife, hereby grant and <br />convey to Kevin R. Miller, for valuable consideration received a lien in the amount of <br />$3,000.00, plus interest at 10 percent per annum, upon the proceeds of any settlement or <br />award received from American Family Mutual Insurance Company or Denton E. Bedell, <br />arising from Claim No. 00- 751 - 033025 -227, a personal injury claim which arose on August <br />16, 1997. <br />Gilbert C. Garcia and Pamela A. Garcia further grant that said sum shall be paid to <br />Kevin R. Miller by their attorney, Thomas A. Wagoner. <br />Gilbert C. Garcia <br />foc,� (3, . <br />Pamela A. Garcia <br />STATE OF NEBRASKA ) <br />) ss. <br />COUNT OF HALL ) <br />Before me, a notary public qualified for said county, personally came Gilbert C. <br />Garcia known to me and to be the identical person or persons who signed the foregoing <br />instrument and acknowledged the execution thereof to be his, her or their voluntary act and <br />deed. <br />Witness Fefatl 'ry i 00 � <br />o ARAL NOTARY-State of Nebraska <br />MARNIE SCRAM SUNDERMEIER <br />M Comm. Exp. Sept. 9, 2003 ✓ l ..1G <br />�' IV ary Pupjc J STATE OF NEBRASKA ) <br />) ss. <br />COUNT OF HALL ) <br />Before me, a notary public qualified for said county, personally came Pamela A. <br />Garcia known to me and to be the identical person or persons who signed the foregoing <br />instrument and acknowledged the execution thereof to be his, her or their voluntary act and <br />deed. A _ <br />Witness my hand and notarial seal on Feb try , 200 <br />/-IN4a'ry P <br />aENERAI. NOTARY -State of Ubmska <br />Iq MARNIE SCHAGER SUNDERMEirS <br />Jifts MY Canrn. Ev. Sept. 8, 2003 <br />