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201807000 <br />':.NEBRASKA CERTIFICATE OF TITLE 1404. <br />��: <br />Vehicle Identification Number <br />182689918268877NE <br />Purchase' Date <br />10/22/2018 <br />GVWR <br />1111 <br />111111 <br />1 <br />1119110111101111111111 <br />Year Make Body Style <br />1973 FLEETWOOD MFGD HOME <br />Model <br />DOUBLE WIDE <br />issue Date Previous Title Number/State Title Type <br />10/22/2018 AFFIDAVIT ORIGINAL <br />Color <br />YEL / WHI <br />Capacity Odometer <br />EXEMPT <br />Owner Name(s) And Address <br />MICHAEL HIEB AND/OR <br />GAIL HIEB WROS <br />6953 W SCHIMMER DR <br />ALDA, NE 68810-9657 <br />1ST Lien <br />2ND Lien <br />Subsequent <br />Liens Filed <br />Legends <br />Previous Owner(s) City/State <br />JOYCE SHAFER <br />ALDA, NE 68810 <br />LIEN RELEASES <br />1st Release By: <br />Title: <br />Date: <br />I;ounty <br />Date: <br />2nd Release By: <br />Title: <br />Date: <br />I;ounty: <br />Date: <br />SELLER MUST COMPLETE PURCHASER'S INFORMATION <br />Federal and State law requires that the seller state the mileage in connection with the transfer of ownership. Failure to complete or providing a false statement may result in fines and/or <br />imprisonment. (RETAIN COPY FOR 5 YEARS.) <br />The undersigned, being the owner of the vehicle described within the Certificate of Title, hereby sells and assigns all right, title and interest in and to said Certificate of Title and the vehicle <br />described therein to the following named purchasers. <br />I certify to the best of my knowledge the odometer reading is the actual mileage of the vehicle unless one of the following statements is checked: <br />❑ 1. The mileage stated is in excess of its mechanical limits. <br />❑ 2. The odometer reading is not the actual mileage. WARNING - ODOMETER DISCREPANCY. <br />ODOMETER READING <br />NO <br />TENTHS <br />CAUTION <br />READ CAREFULLY <br />BEFORE YOU <br />CHECK A BLOCK <br />ALL OWNERS WHOSE NAMES APPEAR <br />ON THE FACE OF THIS TITLE MUST SIGN. <br />SIGNATURE OF SELLER <br />PRINTED NAME OF PURCHASER(S) <br />ADDRESS <br />SIGNATURE OF SELLER CITY <br />SIGNATURE OF SELLER <br />PRINTED NAME OF SELLER (ONLY ONE PRINTED NAME REQUIRED) <br />DATE OF SALE <br />INVENTORY CONTROL NUMBER <br />F 3502222 <br />County Official <br />ALAINA VERPLANK <br />By: CH <br />STATE ZIP <br />I AM AWARE OF THE ODOMETER STATEMENTS <br />MADE BY THE SELLER(S) <br />SIGNATURE OF PURCHASER <br />SIGNATURE OF PURCHASER <br />II, <br />County <br />HALL <br />Witness My Hand And Official Seal The D sit? ,' n Above <br />(County Official's Seal) <br />F03502221 <br />$ 10.00 <br />Title Number <br />18295080110 <br />•�I�.a. >r:.-...---------'�-- --' -`ri:ist1�It�'Y•2.=si'•��t=:t•�SY3: ���•�!�: <br />064 ra.��������i�i�1�1�/�����eeffssysI�i�i��������I�+����iei�1�1�������'�'e'��s�f�:�:�v.VOID IF�ALTERED OR DUPLICA•TE ISSU•ED_...���j���i�!������������ii����.��1��1��••• �1�4�.�0��i�i����14/41�1����i�,���1�1I t tt. <br />� •ru � <br />REV. 07/2013 <br />V'I'1TI.F:1 <br />VIR4 08012017 <br />