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Under penalty of law, the undersigned affirms that the information contained in this Affidavit of Affixture is true and correct and that <br />the above - described mobile home has been affixed to the real property described above. The undersigned hereby acknowledges that <br />this affidavit is made with the understanding that any person who misrepresents the information provided in this affidavit shall be <br />guilty of perjury, a Class III Felony. <br />Jeremy L. Straatmann <br />Printed Name of Mobile Home Owner <br />t — . + % ,•- <br />-'_na . .. . me owner <br />State of <br />County of <br />The foregoing sipiture of the affiant was acknowledged <br />before me this Yht day of l9C Jets , 201 <br />Notaryyr,Designated County Official <br />GENERAL NOTARY -State of Nebraska <br />JERRY L MUNSELL <br />a j <br />My Comm. Exp. November 20, 2017 <br />All owners must sign and signatures must be notarized. <br />Seal <br />Printed Name of Mobile Home Owner <br />Signature of Mobile Home Owner <br />State of <br />County of <br />201507380 <br />The foregoing signature of the affiant was acknowledged <br />before me this day of <br />Notary or Designated County Official <br />Seal <br />Ftl!r County T reasurer Jse c�nIy <br />Aunty of filing O ce cif filing: <br />d ate a fltn :. ,>Fce tiaid.. <br />s in the county where the real property is locate <br />soi owriet and t o each Iinancia utton listef <br />ounty Treasurer shall forward the original to the Register o <br />3, provide copies to the Department of Motor Vehicles, County Asse <br />n this Affidavit as notice of the cancellation of the Certificate of Titl+ <br />3 of 3 <br />Affidavit of Affixture For a Mobile Home With a Nebraska Certificate of Title 6/2014 <br />