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...... rn = <br /> i■Nommi n Z T� <br /> N�� n t" . pcl (r) <br /> _ N <br /> dn Lr, C) - <br /> �� '11 � Z <br /> Ut�� �- <br /> �l tee, <br /> rri "" <br /> r- 70 iv <br /> c> r- r 1—:,' C <br /> a, rell <br /> I rl ._G Gn -ti7 .r.+ <br /> cl ;::n <br /> to CO <br /> Affidavit of Affixture <br /> NEBRASKA For a Mobile Home With a -' - -0 <br /> APARTMENT t F MOTOR VEHICLES o <br /> ` Nebraska Certificate of Title �, � /1' <br /> I0 <br /> AJritten consent for release of lien and cancellation of Certificate of Title from each lien holder must be attached to this <br /> ffidavit. This completed Affidavit must be presented to the County Treasurer along with the Certificate of Title in the <br /> unty 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 /> MMobile/Home Owner#1 Cbee�,Q d\ Mobile Home Owner#2 A <br /> Name C)017414 L C_. °5)t''L S 2 l Name J A Yl F (_- ef3 1 P.-`i <br /> Address 103 'J P,1 t en— Address 11), J u--P i r <br /> City, State Zip A Oa. , N!✓ 1,381 U City, State Zip AI da , Nf a l tS I 0 <br /> Attach additional Affidavit(s)if more than 2 owners. <br /> ® Owner of real estate ❑ Leasing real estate <br /> Mobile Home Description: Year I q q to Make DU( Season S Model 2 % )(1 0 <br /> Vehicle Identification Number FS 2 007 DSO Title Number 602 4,7"-i L $ 2 <br /> If two Vehicle Identification Numbers are present,an Affidavit must be completed for each number. <br /> Real Estate Owner#1 nn i (bee eased Real Estate Owner#2 <br /> Name Do id L e O3! e L..j S�, Name JA f F e ©o le,J <br /> Address 103 J t I c Address 10 s Jtc p , e v <br /> City, State,Zip A taGt f N v E 4 $ (o City, State,Zip /4 id Q N & (D S tS , 0 <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 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 /> 1 of 3 <br /> Affidavit of Affixture For a Mobile Home With a Nebraska Certificate of Title 6/2017 <br />