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201700591
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1/26/2017 4:27:31 PM
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1/26/2017 4:27:31 PM
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DEEDS
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201700591
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7. I will file this affidavit with the Register of Deeds Office of the county in which the <br />real property is located (Hall County); and <br />8. I will file the affidavit and certified or authenticated copy of the death certificate in <br />any other county in Nebraska in which the deceased owns real property that is subject to this <br />affidavit. <br />Date <br />Address (line 1) Y <br />14 b; <br />Address ine 2) <br />Attachment: certified or authenticated copy of Death Certificate <br />NOTARY <br />State of Nebraska, County of Hall <br />This document was acknowledged before me on the aCl day o A(J-(f , 2017, <br />by LEROY C. HOELCK. <br />My commission expires: obi yi" a / / .0/3 <br />Y)Ebth <br />1 otary Pub? <br />201700591 <br />GENERAL NOTARY - State of Nebraska <br />MERRY J. JOHNSON <br />My Comm. Exp. August 21, 2018 <br />
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