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Return to: <br />A <br />m <br />A <br />O <br />G <br />AFFIDAVIT OF MARITAL STATUS <br />STATE OF NEBRASKA ) <br />COUNTY OF // ) SS <br />Daniel E. Roth, being first duly sworn upon oath, deposes and states that he is <br />well and personally acquainted with Thomas Soukup, the Trustors in that certain Deed of Trust <br />dated October 26;2016, and recorded on November 1, 2016, as Instrument No. 201607272 in the <br />office of the Register of Deeds of Hall County, Nebraska, covering lands situated in said County <br />and described as follows: <br />Parcel A: Lot One (1), Block Fifteen (15), Charles Wasmer's Addition to the City of Grand Island, Half <br />County, Nebraska. <br />Parcel B: Lot Sbc (6) and the West Half of Lot Seven (7), Block Thirty-seven (37), Russel Wheeler's <br />Addition to the City of Grand Island, Hall County, Nebraska. <br />Said affiant states that Thomas Soukup, is a single person, notwithstanding the fact that no <br />martial status was Shown on said Deed of Trust. <br />Dated this <br />7f," day of . 44 2 GC-'/ l� 40.3r , <br />SUBSCRIBED in my presence and sworn to before me this r 0 day of <br />1r ArykLt1n) , 20 t( . <br />My Commission expires: c3) ?/ J I <br />GENERAL NOTARY - State of Nebraska <br />ELIZABETH A. GARDUNO <br />My Comm. Exp. March 2, 2017 <br />0 <br />