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Under penalty of law, the undersigned affirms that the information contained in this Affidavit of Affixture is true and correct and that <br />the above - described mobile home has been affixed to the real property described above. The undersigned hereby acknowledges that <br />this affidavit is made with the understanding that any person who misrepresents the information provided in this Affidavit shall be <br />guilty of perjury, a Class lit Felony. <br />J44 /" to FL <br />Printed Name of Mobile HHfne Owtier <br />ature of Mobile Ho wne <br />State of 1ie6ras IlIF� <br />County of Fd ez.l l <br />The foregoing signature of the affiant was acknowledged <br />before me this 13 day of Feb rust ►^z , 2 0 1 . <br />de <br />ignated County Official <br />GENERAL <br />Ph Comm Exp. 14, 2022 <br />No ary or D <br />All owners must sign and signatures must be notarized. <br />Seal <br />Printed Name of Mobile Home Owner <br />Signature of Mobile Home Owner <br />State of <br />County of <br />201801657 <br />The foregoing signature of the affiant was acknowledged <br />before me this day of <br />Notary or Designated County Official <br />Seal <br />r r l` shall lo nal to the R gi ster of fee <br />es to e )epartt icnt of l otor Veln es County Ass <br />as notice o the cancellation of the Certificat of.`i it y <br />where the real proper is ioca <br />d to each nat ei l institution lisl <br />The Cow <br />arid provide cop <br />on this Afftdav <br />ed <br />3 of 3 <br />Affidavit of Affixture For a Mobile Home With a Nebraska Certificate of Title 6/2017 <br />