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Dated this ..... 26............ day of .. .. . �2rr ........................ 2000 On the above date, before me a General N Lary Public duly commissioned and qualified, personally came .............. ........................................... ............................... ..................... ............................... 1, - .I.e -}- ............ � .... e.1, - .....................:. ...........................................................................................,.,�..,,.......... ............................... T &me known to be the identical person whose affixed to the foregoing instrument as grantor � aim acknowledged the same to be a voluntary act and deed. S nd Notarial Seal the day and year above written. No. ........................................................ ............................... co is expires the ............ day of ........... ............................... 2000 200009047 Datedthis ........................... day of ..................................... ............................... AM On the above date, before me a General Notary Public duly commissioned and qualified, personally came ............................................................ ............................... ........................................... :............................................................................................ To me known to be the identical person ....... whose name....... affixed to the foregoing instrument as grantor ........ and acknowledged the same to be a voluntary act and deed. WITNESS my hand and Notarial Seal the day and year above written. Notary....... ............................... ................................................. ............................... My commission expires the ............ day of ........... ............................... 2000 STATE OF ..... C°'.:Z .........W:ft STATE OF ................................... ............................... SS. )t f Nebraska I .............................. CAW .................................... ............................... COUNTY .................. 1, 2002 MEMORANDA PLEASE PRINT ALL NAMES Exact and full name of OWNER, as same appears of record ................................................................................................................._......................... .............................•. . .. .. . .. . . . . . . . .. .. .. . . . . . . . . . . .. .. . . .. . . . . .. . . . . . . . . .. . . ... . ... . . . . . . . . . . . . . .. .. . . . . . . . . .. . . . . .. . . . . . . .. . .. . . . . . . . . . . . . . . . . . . . . . .. . . .. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . ................... . . .. . . . ........................................... . ....................................... Ifmarried, full name of spouse .................................................................................................................................................................................................. ............................... If unmarried, show "single,.. ,.widower,.. "widow .. ................................................................................................................................................................ ............................... If mortgage or other liens, show names of holders, amounts, dates and book page of record .................................................................................. ............................... ............................ . . . . . .. .. . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. .. . . . . . . . . .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .. . . . . . .. . . . .. . . . . . . .. . . . . . . .. ... . . . . . . . . . . . . . .. .. .. . . .. . . .. . . .. . . .. . . .. . . . . . . .. . . .. .... . . . . .. .. . . .. .. .. . . . . . • . . . . . .. . ............................................................................................................................................................................................................................................................ ............................... If an estate, give the names of all the heirs, with the share of each. Show names of spouses of those married ...................................................... ............................... ...................................................... ........................................................................................................................................................................................................ I............................ Nameof executor or administrator ............................................................................................:............................................................................................. ............................... If any of the owners or heirs are minors, give their names and ages ................................................................................................................................ ............................... ........................................................................................................................................................................ ............................... •.................. ............................... •.. ............................... ............................................................................................................................................................................................................................................................ ............................... Nameof guardian .......................................................................................................................................................................................................................... ............................... ..................... :............................ ......................................................................................................................................................................................................................................... TENANT- Exact and full names. Rent Agreement ..........° .............°°--°°--.................................................................-----°----°--........................................ ..... °----.................._.. REMARKS M Y 1� L � �' L°QServ�rl-E ll be res+ar��