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[Check applicable box(es)] <br />❑ Adjustable Rate Rider <br />❑ Graduated Payment Rider <br />❑ Balloon Rider <br />n <br />�I111 � <br />20000243'7 <br />❑ Condominium Rider ❑ 1 -4 Family Rider <br />❑ Planned Unit Development Rider ❑ Biweekly Payment Rider <br />❑ 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 />Borrower DOUGLJkS A. MILLER <br />X pcu� <br />(Seal) <br />Borrower PAMELA M. MI LER <br />(Seal) <br />Borrower (Seal) <br />[Space Below This Line For Acknowledgment] <br />STATE OF Nebraska <br />SS: <br />COUNTY OF Hall <br />I, JON A. HEATH , a Notary Public in and for said county and state, do hereby <br />certify that DOUGLAS A. MILLER and PAMELA M. MILLER Husband and Wife as Joint Tenants with Right <br />of Surivorship <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 />( is, her, t eir) <br />and that they executed said instrument for the purposes an uses 141reln set forth. <br />(he, she, they) <br />Witness my hand and official seal this 24th day of March 2000 <br />My Commission Expires: JANUARY 9, 2003 <br />����_______ SEAL <br />GENERAL NOTARY-State of NetNaska J A. T <br />This instrument was prepared b : JON A. HEATH <br />MY Comm. UP. Jan. 9, 2003 <br />Form 3028 9/90 <br />F1029.1-MG (10/99) Page 5 of 5 <br />