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[Check -applicable box(es)] <br />❑ <br />Adjustable Rate Rider <br />❑ <br />Condominium Rider <br />❑ <br />Graduated Payment Rider <br />❑ <br />Planned Unit Development Rider <br />❑ <br />Balloon Rider <br />❑ <br />Rate Improvement Rider <br />® <br />VA Rider <br />❑ <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 rider(s) <br />executed by Borrower and recorded with it. <br />Witnesses: <br />STATE OF Nebraska <br />COUNTY OF Hall <br />(Seal) <br />Borrower Kellf 0 Flatness <br />�`�1- ✓ - ��/� �✓I - Z i/I�/ (Seal) <br />Borrower Eliza P Flatness <br />Borrower <br />Borrower <br />[Space Below This Line For Acknowledgment] <br />i ss: <br />(Seal) <br />(Seal) <br />I, William L McLellan , a Notary Public in and for said county and state, do hereby <br />certify that Kelly 0 Flatness and Eliza P Flatness , 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 instrument <br />have executed same, and acknowledged said instrument to be their , free and voluntary act and deed and that they <br />(his, her, their) (he, she, they) <br />executed said instrument for the purposes and uses therein set forth. <br />Witness my hand and official seal this 28th day of April , 2000 <br />My Commission Expir : <br />.," Rr h'/ f pATA�9 <br />14,V <br />A <br />This instrument was prepared by: <br />(Seal) <br />William L M ellan <br />Form 3028 9/90 <br />F4009.LMG (11/99) Page 5 of 5 <br />200003498 <br />❑ <br />1 -4 Family Rider <br />❑ <br />Biweekly Payment Rider <br />❑ <br />Second Home Rider <br />BY SIGNING BELOW, Borrower accepts and agrees to the terms and covenants contained in this Security Instrument and in any rider(s) <br />executed by Borrower and recorded with it. <br />Witnesses: <br />STATE OF Nebraska <br />COUNTY OF Hall <br />(Seal) <br />Borrower Kellf 0 Flatness <br />�`�1- ✓ - ��/� �✓I - Z i/I�/ (Seal) <br />Borrower Eliza P Flatness <br />Borrower <br />Borrower <br />[Space Below This Line For Acknowledgment] <br />i ss: <br />(Seal) <br />(Seal) <br />I, William L McLellan , a Notary Public in and for said county and state, do hereby <br />certify that Kelly 0 Flatness and Eliza P Flatness , 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 instrument <br />have executed same, and acknowledged said instrument to be their , free and voluntary act and deed and that they <br />(his, her, their) (he, she, they) <br />executed said instrument for the purposes and uses therein set forth. <br />Witness my hand and official seal this 28th day of April , 2000 <br />My Commission Expir : <br />.," Rr h'/ f pATA�9 <br />14,V <br />A <br />This instrument was prepared by: <br />(Seal) <br />William L M ellan <br />Form 3028 9/90 <br />F4009.LMG (11/99) Page 5 of 5 <br />