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200007854 <br />[Check applicable box(es)) <br />❑ Adjustable Rate Rider ❑ Condominium Rider ❑ 1-4 Family Rider <br />❑ Graduated Payment Rider ❑ Planned Unit Development Rider ❑ Biweekly Payment Rider <br />❑ Balloon Rider ❑ Rate Improvement Rider ❑ Second Home Rider <br />® VA Rider ❑ Other(s) [Specify] <br />BY SIGNING BELOW, Borrower accepts and agrees to the terms and covenants contained in this Security Instrument and in any riders) <br />executed by Borrower and recorded with it. <br />Witnesses: <br />(Seal) <br />Borrower 4avid G reen <br />(Seal) <br />Borrower Ellen I, Nelson-Green , <br />(Seal) <br />Borrower <br />(Seal) <br />Borrower <br />[Space Below This Line For Acknowledgment] <br />STATE OF Nebraska <br />COUNTY OF Hall <br />f ss: <br />I, Sherri L O'Callaghan ' a Notary Public in and for said county and state, do hereby <br />certify that David A. Green and Ellen 1. Nelson -Green husband and wife <br />personally appeared before me and is (are) known to me to be the person(s) who, being informed of the contents of the foregoing instrument <br />have executed same, and acknowledged said instrument to be their , free and voluntary act and deed and that they <br />(his, her, their) (he, she, they) <br />executed said instrument for the purposes and uses therein set forth. <br />Witness my hand and official seal this 20th day of September 2000 <br />My Commission Expires: <br />GENERAL NOTARY-Stale of Nebraska <br />�!I <br />AO I SHERRI L. O'CALLAGHA (I) <br />My Comm. Exp. Sept. 28, 2003 erri L Olag <br />'C han <br />This instrument was prepared by: <br />Form 3028 9/90 <br />F400911VIG (8/00) Page 5 of 6 <br />