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Amick Acres_S <br />d Subdivision <br />202001655 <br />We, the undersigned, hereby affirm our vote in favor of adopting the <br />Amended Agreement for Protective Covenants, Restrictions, and Conditions for the <br />"Amick res Subdivision" and the "Amick Acres Second Subdivision". <br />1;1 /I &4.0-v( <br />Printed Name <br />Address ( Z / l? ASD 101 A -v <br />Signature <br />Printed Name <br />re/-,402-7 <br />Lot(s) Owned, (Legal Description) <br />STATE OF NEBRASKA <br />SS: <br />COUNTY OF HALL <br />SUBSCRIBED AND SWORN to fore me this v day of <br />-10a> ekti s -Tu ) e- ) C.)) bliV-0a)k- <br />eAk-O-LA <br />GENERAL NOTARY - State of Nebraska <br />!'M KARLA A. COLLINSON <br />My Comm. Exp. August 16. 2023 <br />Notary Public <br />