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201905135
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8/26/2019 10:58:16 AM
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8/26/2019 10:58:16 AM
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DEEDS
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201905135
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CCC -297 (12-21-17) Page 2 of 2 <br />IN WITNESS WHEREOF, the undersigned parties hereto have executed this instrument <br />this (h) 22nd day of (i) August 0) 2019 (year). <br />if a corporation: <br />By <br />Micha•1 A. Seda <br />(k) Name of Corporate (Mortgagee) (Owner) * (n) Individual (Mortgagee) (Owner) * <br />- <br />Roberta K. Seda <br />(1) Duly Authorized Officer (o) Individual (Mortgagee) (Owner) * <br />(m) Title <br />CORPORATE <br />SEAL <br />"Mortgagee" includes holder of any type of real estate lien. <br />*Delete "Mortgagee" or "Owner." <br />(p) STATE OF Nebraska <br />(q) COUNTY OF Platte <br />ss. ACKNOWLEDGMENT: <br />On this (r) 22 day of (s) August in the year (r) 2019 , before me, the undersigned, a Notary <br />Public in and for said State, personally appeared (u) Michael A. Seda and Roberta K. Seda <br />personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) <br />subscribed to the within instrument and acknowledged to me that he/she executed the same in his/her/their capacity (ies), and <br />that by his/her/their signature(s) on the instrument, the individual(s) or the person on yehalf of which the individual(s) acted, <br />execute the instrument. <br />(SEAL) '— <br />GENERAL NOTARY - State of PJt oaska <br />STACIE L RICKERT <br />My Comm. Exp. April 2S, 2021 <br />My commission expires (tv) <br />Stacie L. Rickert <br />(i) Notary Public <br />09-28-2021 <br />(MM-DD-YYYY) <br />NOTE: <br />The following statement is made in accordance with the Privacy Act of 1974 (5 USC 552a - as amended). The authority for requesting the information <br />identified on this form is 7 CFR Part 1436, the Commodity Credit Corporation Charter Act (15 U.S.C. 714 et seq.), and the Agricultural Act of 2014 (Pub. <br />L. 113-79). The information will be used to determine eligibility to participate in and receive benefits under the Farm Storage Facility Loan Program <br />through documentation of a severance agreement when there are real estate lien holders involving the land where a storage structure is to be located. <br />The information collected on this form may be disclosed to other Federal, State, Local government agencies, Tribal agencies, and nongovernmental <br />entities that have been authorized access to the information by statute or regulation and/or as'described in applicable Routine Uses identified in the <br />System of Records Notice for USDA/FSA-14, ApplicantBorrower Providing the requested information is voluntary. However, failure to furnish the <br />requested information will result in a determination of ineligibility to participate in and receive benefits under the Farm Storage Facility Loan Program. <br />This information collection is exempted from the Paperwork Reduction Act, as specified in the Agricultural Act of 2014 (Pub. L. 113-79, Title I Subtitle F. <br />Administration). The provisions of criminal and civil fraud, privacy and other statutes may be applicable to the information provided. RETURN THIS <br />COMPLETED FORM TO YOUR COUNTY FSA OFFICE. <br />�£TS06JOZ <br />
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