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202302862 <br />Under penalty of law, the undersigned affirms that the information contained in this Affidavit of Affixture is true and correct and that <br />the above-described mobile home has been affixed to the real property described above. The undersigned hereby acknowledges that <br />this affidavit is made with the understanding that any person who misrepresents the information provided in this Affidavit shall be <br />guilty of perjury, a Class III Felony. <br />All owners must sign and signatures must be notarized. <br />1<-111113 S l G L - <br />Printed Name of Mobile Home Owner <br />Signature of Mobile Home Owner <br />State of %1:4,p' -s KA <br />County of fT ALL-- <br />The foregoing si <br />before me this— <br />of the,dffiant was acknowledged <br />—day of_ q/(i'. <br />J <br />No . ry or Designated County Of c' .1 <br />GENERAL NOTARY - State of brute <br />ROBIN E. CLAY <br />IN Comm. Exp. July 19, 2028 <br />Seal <br />Printed Name of Mobile Home Owner <br />Signature of Mobile Home Owner <br />State of <br />County of <br />The foregoing signature of the affiant was acknowledged <br />before me this day of <br />Notary or Designated County Official <br />Seal <br />For County Treasurer Use Only <br />County of filing1 <br />Date of filing: LLfl • 3, <br />Office of <br />i t orr No DAs <br />Fee paid: ' t'a <br />The. County Treasurer shall forward the, original to the Register of Deeds in the county where the real, property is located <br />and provide copies to the Department of Motor Vehicles, County Assessor, owner and to each financial institution' listed <br />on this Affidavit as notice of the cancellation of the Certificate of Title. <br />3 of 3 <br />Affidavit of Affixture For a Mobile Home With a Nebraska Certificate of Title <br />6/2017 <br />