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�4 <br />[Check applicable box(es)] <br />200008508 <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] Assignment of Rents 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 />�Lw� 64,67- (Seal) <br />Borrower Sandra J. Rost <br />(Seal) <br />Borrower <br />(Seal) <br />Borrower <br />(Seal) <br />Borrower <br />[Space Below This Line For Acknowledgment] <br />STATE OF Nebraska <br />COUNTY OF Hall f ss: <br />I, William L McLellan , a Notary Public in and for said county and state, do hereby <br />certify that Sandra J. Rost an unmarried individual <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 her free and voluntary act and deed <br />Is, her, t eir <br />and that She executed said instrument for the purposes arm uses tie Gin set forth. <br />(he, she, they) <br />Witness my hand and official seal this 16th day of October 2000 <br />My Commission Expires <br />ll/ gFNfgq� � <br />NQ SEAL <br />Oo- TggYStar William L McLellan <br />This instrument was prepared by:yC�mm Fp McbFN�braska <br />AU9 >Z 49 <br />Form 3028 9 /60 <br />F10291100 (10/69) Page 5 of 5 <br />