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Mobile Home Owner #1 <br />Name Krissa Abraham <br />Address <br />.Yam <br />I 1 . <br />1i <br />City, State Zip -c., .1 ; tc, , f 1...I-. CpA'� <br />Real Estate Owner #1 <br />Name Same <br />Affidavit of Affixture <br />For a Mobile Home With a <br />Nebraska Certificate of Title <br />Written consent for release of lien and cancellation of Certificate of Title from each lien holder must be attached to this <br />Affidavit. This completed Affidavit must be presented to the County Treasurer along with the Certificate of Title in the <br />county where the real property is located for cancellation of the existing Certificate of Title to occur. <br />A filing fee is required per §33 -109 and §33 -112. <br />Mobile Home Owner #2 <br />Name <br />Address <br />City, State Zip <br />Attach additional Affidavit s) if more than 2 owners. <br />Owner of real estate ❑ Leasing real estate <br />Mobile Home Description: Year 2002 Make C Valley Homes Model <br />Vehicle Identification Number 170559917055597NE Title Number <br />If two Vehicle Identification Numbers are present, an Affidavit must be completed for each number. <br />Real Estate Owner #2 <br />Name <br />Address Address <br />City, State, Zip City, State, Zip <br />Attach additional Affidavit(s) if more than 2 entities are to be notified. <br />Copy of Notice of Cancellation shall be provided to all owners listed above and the following financial institution(s): <br />Name Moria Development Inc Name <br />Address 3215 W Ray Rd <br />City, State, Zip Chandler, AZ 85226 <br />Address <br />City, State, Zip <br />Attach additional Affidavit(s) if more than 2 entities are to be notified <br />1 of 3 <br />Affidavit of Affixture For a Mobile Home With a Nebraska Certificate of Title <br />6/2014 <br />rrt <br />czr <br />