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N <br />a <br />®111111M1 <br />W <br />co <br />STATE OF NEBRASKA <br />SS <br />COUNTY OF ) <br />C11 <br />Return to: IMAIT 1 Z 1 L <br />Dated this <br />My Commission expires: <br />AFFIDAVIT OF MARITAL STATUS <br />Tricia Camplin, being first duly sworn upon oath, deposes and states that, she is <br />well and personally acquainted with Kevin Duryee aka Kevin Patrick Duryee, the Grantor in that <br />certain Warranty Deed dated October 21, 2016 and recorded January 18, 2017 as Instrument <br />#201700400, in the office of the Register of Deeds of Hall County, Nebraska, covering lands <br />situated in said County and described as follows: <br />Lot Three (3) in Block Seventeen (17), in the Original Town, now City of Grand Island, Hall County, <br />Nebraska. <br />Said affiant states that Kevin Duryee aka Kevin Patrick Duryee is a single person, <br />notwithstanding the fact that no marital status was shown on said Warranty Deed. <br />is amplin - <br />rn to before e this <br />day of <br />T <br />SUB RIBED in resence and sw <br />L ,207' <br />GENERAL NOTARY - State of Nebraska <br />AMY J. CONKLIN <br />December 29, 2020 <br />, 20 <br />1C <br />day of <br />-4 <br />co <br />