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201600979 <br />Ow <br />t NEBRASKA CERTIFICATE OF TITLE ; <br />1ST Lien <br />2ND Lien <br />Previous Owner(s) <br />RICK HIEB <br />ALDA, NE 68810 <br />Body Style <br />MFG HOME <br />Legends <br />Title Type <br />ORIGINAL <br />Vehicle Identification Number ' Year Make <br />GDMHKS26848575AB 1984 BONNAVILLA <br />Purchase Date <br />2/17/2009 <br />G V W R Capacity <br />Owner Name(s) And Address <br />TODD PEARSON <br />201 MYRTLE ST <br />PO BOX 184 <br />ALDA, NE 68810-9700 <br />Subsequent <br />Liens Filed <br />Model <br />28 X 50 <br />Issue Date Previous Title Number /State <br />2/17/2016 AFFIDAVIT <br />Color <br />TAN <br />Odometer <br />EXEMPT <br />LIEN RELEASES <br />l st Release By <br />Title: <br />Lounty <br />2nd Release By: <br />Title: <br />.;ounty: <br />Dater <br />Date: <br />Date: <br />SELLER MUST COMPLETE <br />Federal and State law requires that the seller state the mileage in connection with the transfer of ownership. Failure to complete or providing a false statement may result in fines and /or '. <br />imprisonment (RETAIN COPY FOR 5 YEARS.) <br />The undersigned, being the owner of the vehicle described within the Certificate of Title, hereby sells and assigns all right, title and interest in and to said Certificate of Title and the vehicle <br />described therein to the following named purchasers. <br />I certify to the best of my knowledge the odometer reading is the actual mileage of the vehicle unless one of the following statements is checked_ <br />❑ 1. The mileage stated is in excess of its mechanical limits. <br />❑ 2. The odometer reading is not the actual mileage. WARNING — ODOMETER DISCREPANCY. <br />CAUTION <br />READ CAREFULLY <br />BEFORE YOU <br />CHECK A BLOCK <br />ALL OWNERS WHOSE NAMES APPEAR <br />ON THE FACE OF THIS TITLE MUST SIGN. <br />1'• <br />►11». <br />,fo . <br />qr. i•■ <br />i -iM' <br />••• ";:e <br />yam• <br />► . 1I, <br />41W <br />i1� <br />►� ♦II <br />. 1 .,1 <br />• <br />� �1 n • , <br />1• <br />»r <br />,01Y • • i ii ' I=s''1.i 1 : 1 W at:, • �� t 11t i s ' i1 <br />Joy <br />1 # 4 .01.x.•1 ..l•1 ...Q4/14.4 j - i" t•! <br />SIGNATURE OF SELLER <br />SIGNATURE OF SELLER <br />SIGNATURE OF SELLER <br />PURCHASER'S INFORMATION <br />PRINTED NAME OFPURCHASER(S) <br />I AM AWARE OF THE ODOMETER STATEMENTS <br />MADE BY THE SELLER(S) <br />Title Number <br />16048080132 <br />INVENTORY CONTROL NUMBER <br />County Official <br />PEGGY L PESEK <br />By: CH <br />SIGNATURE OF PURCHASER <br />SIGNATURE OF PURCHASER <br />► ! <br />County <br />HALL <br />Witness My Hand And Official Seal The Da n Al <br />$ 1 0.0 0 <br />PRINTED NAME OF SELLER (ONLY ONE PRINTED NAME REQUIRED) <br />DATE OF SALE <br />• <br />Aviv IOID IF �� ERED OR � DUPL ICATE:::SSUED _..; ����' 1�1�! ltee R44i! ���l��j+ l�i��!! ��-! Qi.174�jl��i !i!�!�!'!�!�!�li���j�1�1�i���•` <br />� �� <br />REV. 07 /2073 <br />VTITLE1 V1R0 07082010 <br />