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[Check applicable box(es)] 9 9 110 4 8 9 <br /> ❑ Adjustable Rate Rider ❑ Condominium Rider ❑ 1-4 Family Rider <br /> ❑ Graduated Payment Rider ❑ Planned Unit Development Rider ❑ Biweekly Payment Rider <br /> • ❑ Balloon Rider ❑ Rate Improvement Rider ❑ Second Home Rider <br /> � vA Rider � Other(s) (speci�y� VA Assumption Rider <br /> BY SIGNING BELOW, Borrower accepts and agrees to the terms and covenants contained in this Security Instrument and in any rider(s) <br /> executed by Borrower and recorded with it. <br /> W itnesses: <br /> �� 1�2`}�� <br /> � (Seal) <br /> eo��oWe� aniel L. Fiala <br /> ,' el�� V� � (3eal <br /> ��Wa� Emalen J. ia a <br /> (sea�) <br /> sorrower <br /> (Seal) <br /> so«oWa� <br /> [Space Below This Line For Acknowledgment] <br /> STATE OF Nebraska <br /> � ss: <br /> COUNTY OF Hall <br /> I, Rarolyn Vonderohe , a Notary Public in and for said county and state, do hereby <br /> certify that Daniel L. Fiala and Emalene J. Fiala , Husband and Wife, As Joint Tenants <br /> personally appeared before me and is (are) known to me to be the person(s) who, being informed of the contents of the foregoing instrument <br /> have executed same, and acknowledged said instrument to be their , free and voluntary act and deed and that thev <br /> (his, her, thelr) (he, she, they) <br /> executed said instrument for the purposes and uses therein set forth. <br /> Witness my hand and official seal this 29th day of OCtober , 1999 <br /> My Commission Expires: �1 aU��� � '�JQ`?� <br /> L <br /> GENERAL NOTARY�SIate oi Nebraska �'� O �. (Seal) <br /> III � KAROLYN VONDERONE — <br /> �+ My Com��n.Exp. `��=� <br /> This instrument was prepared by: <br /> Form 3028 9/90 <br /> F4009.LM0 (10/98) Page 5 oi 5 <br />