Laserfiche WebLink
• 20220736c <br />ID- `.(-�oa2 <br />Date <br />q.1 c44 s�rand l'etex4 <br />Address (line 1) <br />Address (line 2) <br />Sianture <br />(do NOT sign UNTIL A ' •TARY IS PRESENT AND WITNESSES YOU SIGNING) <br />Attachment: certified or authenticated copy of Death Certificate <br />RENEflN. NOTARY - State of Nebraska <br />KARUE RANDOLPH <br />My Comm. Exp. July 27,2026 <br />• <br />This document was acknowledged before me bva(' T 1J'> <br />this ,1-14't'`• day of0d-bloeA,K• 20 &a. <br />GorlL,t)d7 '-"-' Notary commission expires: O\ ( /a (-P <br />Sianature of Judae/Clerk of the Court/Notary Public <br />Title:%in6 ' &f Serial Number (if any): <br />Page 2 of 2 <br />Affidavit for Transfer of Real Property without Probate <br />CC 15.41 New 07/14 <br />Pro Se Committee <br />Neb. Rev. Slat 03024,129 <br />