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202001548 <br />Claimant Name: Amick Acres West Homeowners Association (AAW-HOA) <br />Claimant Address: PO Box 17, Doniphan, NE 68832 <br />Contact Telephone: 308-379-2265 <br />LIEN FOR ROAD REPAIRS ASSESSMENT AND HOMEOWNERS ASSOCIATION DUES <br />Name of Property Owner: <br />Property Address: <br />Jeret Q. Hammond <br />311 Renee Road, Doniphan, NE 68832 <br />(SOUTH PLATTE TWP AMICK ACRES WEST SUB LT 38) <br />Ac \\ C.-OLL ehrasKc. <br />Said Claimant claims a Lien upon the following -described property, to -wit: <br />SOUTH PLATTE TWP AMICK ACRES WEST SUB LT 38 (Commonly known as: 311 Renee Rd, Doniphan, NE <br />68832). <br />This claim is for unpaid road repair assessments and annual homeowner's association dues, totaling $2,200.00 <br />(Two Thousand, Two Hundred Dollars), a copy of said charges is hereto attached and made a part of this <br />statement. <br />/// da=e6 <br />aimant (Theresa Castleberry, re sentative for the Amick Acres West Homeowners Association Board) <br />State of Nebraska, Hall County,ss: <br />Theresa Castleberry, representative of the Amick Acres West Homeowners Association, of lawful age, being first <br />duly sworn, upon oath says: That she is the representative of the Claimant mentioned in the foregoing Statement <br />of Lien; that he had read said statement and knows the contents thereof; that the name of the owner, the name of <br />the Claimant, the description, the property upon which the lien is claimed, and the items of the account as therin set <br />forth, are just, true, and correct. <br />Subscribed and sworn to before me this I ' day of Akkitk <br />My commission expires: 10 -077 <br />,202 <br />GENERAL NOTARY - State of Nebraska <br />TRACY L. OVERSTREET GARTNER <br />My Comm. Exp. October 27, 2020 <br />