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200403499 <br />Name and address of Beneficiary: <br />1043 South Locust Street <br />Grand Island, NE 68801 <br />STATE OF NEBRASKA <br />SS: <br />COUNTY OF HALL <br />The foregoing instrument was acknowledged before me on <br />�11J f 2004, by Marvin A. Diaz, a single person. <br />�au.NOTaRr•s�a <br />DONALD K ROUTH <br />EqLAn 26.2W N tary Public <br />My commission expires: <br />