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CCC-297 (12-10-24) <br />IN WITNESS WHEREOF, the undersigned parties hereto have executed this instrument <br />s//y <br />this (h) day of (i) <br />By <br />Patrick J. McGuire <br />Trustee of the Patrick 1 McGuire Revocable Living Trust (Owner) <br />(p) STATE OF /V CYnn/���+-S IC4 <br />�-i� (q) COUNTY OF sv C.lo <br />0) 2025 <br />Page 2 of 2 <br />(year). <br />} <br />Angela MNjkkel <br />Trustee of the Angela M. Nickel Revocable Trust (Owner) <br />ss. ACKNOWLEDGMENT: <br />On this (r) e day of (s) )10 1 > in the year (t) 20.25- before me, the undersigned, a <br />Notary Public in and for said State, personalty appeared (u) Patrick J. McGuire and Angela M. Nickel <br />personalty known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) <br />subscribed to the within instrument and acknowledged to me that he/she executed the same in his/her/their capacity (ies), and <br />that by his/her/their signature(s) on the instrument, the individual(s) or the person on behalf of which the individual(s) acted, <br />execute the instrument. <br />XEMBIALNOTAFN MOL of Nebraska <br />My Comm Exp. Fehuary 13, 2028 <br />SEAL) <br />My commission expires (w) <br />(v) Notary Public <br />(MM-DD-YYYY) <br />NOTE: The following statement is made in accordance with the Privacy Act of 1974 (5 USC 552a - as amended). The authority for requesting the information identified on <br />this form is 7 CFR Part 1436, the Commodity Credit Corporation Charter Act (15 U.S.C. 714 et seq.), and the Agricultural Act of 2014 (Pub. L. 113-79). The <br />information will be used to determine eligibility to participate in and receive benefits under the Farm Storage Facility Loan Program through documentation of a <br />severance agreement when there are real estate lien holders involving the land where a storage structure is to be located. The information collected on this form <br />may be disclosed to other Federal, State, Local govemment agencies, Tribal agencies, and nongovemmental entities that have been authorized access to the <br />information by statute or regulation and/or as described in applicable Routine Uses identified in the System of Records Notice for USDA/FSA-14, <br />ApplicantBorrower. Providing the requested information is voluntary. However, failure to fumish the requested information will result in a determination of <br />ineligibility to participate in and receive benefits under the Farm Storage Facility Loan Program. <br />This information collection is exempted from the Paperwork Reduction Act, as specified in the Agricultural Act of 2014 (Pub. L. 113-79, Title 1 Subtitle F. <br />Administration). The provisions of criminal and civil fraud, privacy and other statutes may be applicable to the information provided. RETURN THIS COMPLETED <br />FORM TO YOUR COUNTY FSA OFFICE. <br />