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f• <br />200405406 <br />WITNESS, THE HAND AND SEAL OF THE SAID GRANTORS: <br />Witness <br />Print Name <br />Address: <br />/ q <br />R' FIELD f d <br />R USZAK <br />Witness <br />Print Name <br />Address: <br />State of Nebraska, City /County of d ' vJZ1, ,W1 /11ce <br />I HEREBY CERTIFY that on this 30- day of �QJ <br />2W#, before me, the subscriber, a Notary Public of the State Aforesaid, personally appeared the <br />within named Grantor, JENNY R EMPFIELD, f/k/a JENNY R. KUSZAK, known to be (or <br />satisfactorily proven to be) the person whose name is subscribed to the within instrument and <br />acknowledged the foregoing Deed to be his act, and in my presence signed and sealed the same. <br />IN WITNESS WHEREOF, I hereunto set my hand and official seal. <br />d bksrir <br />r Notary PabH BEVERLY J. BREWER <br />My commission expires: ( , jy A2, ,_--9 O _ p <br />�� Yy Comm ficp. <br />No tide search was performed on the subject property. The preparcr of this deed maker <br />title nor property use or any zoning regulations concerning described property herein conveyed nor any matter except the validity <br />of the form of this instrument. Information herein was provided to prepares by Grantor /Grantee and /or thefr agents, no boundary <br />survey was made at the time of this conveyance. <br />Prepared by: <br />W3gism E. OnVbey do Assoc. <br />2605 Eoterpese Road, Earl <br />Suite 155 <br />Clearwater, Florida 33739 <br />Page 3 of 3 <br />I <br />