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[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 />® Other(s) [specify] Assign of Rents & Mtg. Ins. <br />BY SIGNING BELOW, Borrower accepts and agrees to the terms and covenants contained in this Security Instrument and In any <br />rider(s) executed by Borrower and recorded with it. <br />Witnesses: <br />(Seal) <br />row Linda F. Addison <br />��— (Seal) <br />Bo ow r Larry <br />11-son <br />(Seal) <br />Borrower <br />(Seal) <br />Borrower <br />(Space Below This Line For Acknowledgment) <br />STATE OF Nebraska <br />COUNTY OF Hall SS: <br />I, William L McLellan a Notary Public in and for said county and state, do hereby <br />certify that Linda F. Addison and Larry G. , wife and husband <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 <br />instrument, have executed same, and acknowledged said instrument to be their , free and voluntary act and deed <br />Is, her, t sir <br />and that they executed said instrument for the purposes A uses t�i Sin set forth. <br />(he, she, they) <br />Witness my hand and official seal this 22nd day of September 2000 <br />My Commission Expires: ' <br />L <br />SEAL <br />illfam L McLell <br />This instrument was prepared by: 99(NQT <br />ioni /qM< Aafro/ <br />ni Fxp MO�F N�b�as%r <br />Oq <br />Form 3028 9 /90 <br />F1029.LM0 (10/99) Page 5 of 5 <br />