Laserfiche WebLink
[Check applicable box(es)] <br />200007898 <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 />❑X Other(s) [Specify] Assign of Rents & PMI Rider <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 />4LA (Seal) <br />Borro r hris A <br />i A9A <br />(Seal) <br />anelle L. ormu h <br />Borrower <br />Borrower <br />[Space Below This Line For Acknowledgment] <br />STATE OF Nebraska <br />ss: <br />COUNTY OF Hall <br />(Seal) <br />(Seal) <br />I, LkJ f' < ', U L • &-� LdA (I JA--- , a Notary Public in and for said county and state, do hereby <br />certify that Chris A. Wormuth and Janelle L. Wormuth 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 <br />instrument, have executed same, and acknowledged said instrument to be their free and voluntary act and deed <br />(his, her, t eir) <br />and that they executed said instrument for the purposes and uses t ereln set forth. <br />(he, she, they) <br />Witness my hand and official seal this 15th day of September 2000 <br />My Commission Expire <br />�Y(a SEAL <br />This instrument was prepared by. Oj <br />�� <br />Form 3028 9/90 <br />F1029.LMG (10/99) Page 5 of 5 <br />