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200403796 <br />State of Nebraska Space Above This Line For Recording Data <br />DESIGNATION OF HOMESTEAD <br />I have elected to make a designation of homestead as provided for in the Farm Homestead Protection Act. <br />The designated homestead is located on real estate which is encumbered by the attached mortgage or deed <br />description of such real estate, which is designated as homestead, is as follows: <br />Lots One, Two, Three on Mainlande and the Southwest Quarter of Section 14, in Township 9 North, Range <br />P.M. Hall County Nebraska <br />of trust. The legal <br />11 West of the 6th <br />I reside in a dwelling house located upon the homestead. All appurtenances to such dwelling, an adequate supply of potable water and <br />an adequate system of sewage disposal exist upon the homestead. Both the water supply and the sewage disposal system are located <br />entirely upon the homestead and neither will require access to or an easement across any part of the nondesignated agricultural land <br />encumbered by such mortgage or trust deed. Both the homestead and the nonhomestead real estate encumbered by such mortgage or <br />trust deed have existing legal access to a public roadway. All structures and other improvements situated on the portion of the homestead <br />encumbered by such mortgage or trust deed are listed below. These structures and improvements are within the homestead boundary and <br />do not encroach upon any of the nonhomestead real estate encumbered by such mortgage or trust deed. <br />List of structures and improvements situated on the portion of the homestead encumbered <br />This Designation shall be made a part of the attached mortgage or deed of trust. <br />Dated: o (i <br />Dated <br />State of Nebraska <br />County of Hall <br />04 <br />Rainforth <br />Patricia D. Rainforth <br />rustor <br />The foregoing instrument was acknowledged before me this30th day of March, 2004 , <br />by Daniel J. Rainforth; Patricia D. Rainforth <br />GENERAL NOTARY-State of Nebraska <br />ib T E. WILTFONG <br />My Comm. Up. Dec. 11, 2004 <br />©1987 Bankers Systems, Inc., St. Cloud, MN Form DOH- LAZ -NE 10/10/95 <br />My commission expires: 12-11-2004 <br />Notary d6blic <br />Scott E. Wiltfong <br />(page 1 of 1) <br />