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STATE OF NEBRASKA <br />200503836 <br />COUNTY OF <br />aDO3 <br />The foregoing instrument was acknowledged before me this f" (date) by <br />©„ (name of person acknowledged). <br />No P lic <br />Caocb I Grp„ Ea n <br />Print Nam <br />My Commission Expires: <br />GENERAL NQTARY Slate MetxasMa <br />GUAGALUEE C 3` 70 <br />My Comm - �. <br />Grantor(s) Name, Address, phone: Grantee(s) Name, Address, phone: <br />•.�LSra�..P�rl � Cl e_ 1� � V E.c' c�, (•rte) is `-iTl - Ga � l CF, <br />Lk Q 1 Av t., <br />SEND TAX STATEMENTS TO GRANTEE <br />