Laserfiche WebLink
!� l b 4 5 53u <br />Affidavit of Affixture <br />NEBRA&14A For a Mobile Home With a <br />DEPARTMENT OF MOTOR VEHICLES Nebraska Certificate of Title <br />CASH <br />CHECK_�g <br />REFUNDS: <br />CASH <br />CHECK <br />HALL t:,i` . `N'?Y NE <br />loth __} 3: 38 <br />\r_G S L-ii OF ' DEEDS <br />"'LEVS <br />Written consent for release of lien and cancellation of Certificate of Title from each lien holder must be attached to this <br />Affidavit. This completed Affidavit must be presented to the County Treasurer along with the Certificate of Title in the <br />county where the real property is located for cancellation of the existing Certificate of Title to occur. <br />A filing fee is required per §33-109 and §33-112. <br />Mobile Home Owner #1 <br />Name James R. Smith <br />Address 412 N Cherokee <br />City, State Zip Grand island, NF. 68803 <br />Mobile Home Owner #2 <br />Name <br />Address <br />City, State Zip <br />Attach additional Affidavit(s) if more than 2 owners. <br />® Owner of real estate <br />❑ Leasing real estate <br />Mobile Home Description: Year 1970 Make Ritz -Craft <br />Model Venture 3 BR FR <br />Vehicle Identification Number 70472940 Title Number 19249080032 <br />If two Vehicle Identification Numbers are present, an Affidavit must be completed for each number. <br />Real Estate Owner #1 <br />Name James R. Smith <br />Address 412 N Cherokee Ave <br />City, State, Zip Grand island Nebraska 6R803 <br />Real Estate Owner #2 <br />Name <br />Address <br />City, State. Zip <br />Attach additional Affidavit(s) if more than 2 entities are to be notified. <br />Copy of Notice of Cancellation shall be provided to all owners listed above and the following financial institution(s): <br />Name <br />Address <br />City. State, Zip <br />Name <br />Address <br />City, State. Zip <br />Attach additional Affidavit(s) if more than 2 entities are to be notified <br />1 of 3 <br />Affidavit of Affixture For a Mobile Home With a Nebraska Certificate of Title <br />6/2017 <br />