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200310421 <br />State of Nebraska Space Above This Line For Recording Data <br />DISCLAIMER OF RIGHT TO DESIGNATE HOMESTEAD <br />Each of the undersigned states as follows: <br />Non - Homestead <br />® 1 intend to grant a security interest in real property legally described on the attached mortgage or deed of <br />trust. No part of my homestead is presently situated on said real estate, nor will any of my homestead be <br />situated on said property in the future. However, if I establish a homestead on any part of said real estate <br />during the time the mortgage or deed of trust remains unsatisfied and is a lien upon the real estate, I will have <br />no right to make a designation of homestead in the event of a foreclosure or trustee's sale upon such mortgage <br />or deed of trust. <br />Homestead <br />❑ I intend to grant a security interest in real property legally described on the attached mortgage or deed of <br />trust. My homestead is located on said real estate, and I understand I have the right to make a designation of <br />homestead in the mortgage or deed of trust. If I waive or disclaim the right to designate my homestead I am <br />waiving rights, that I would otherwise have, to retain my homestead in the event of default upon such <br />mortgage or deed of trust. I hereby waive and disclaim the right to designate my homestead. <br />I have read the paragraph checked above, and I understand the contents of that paragraph. <br />This disclaimer was signed before execution of the mortgage or deed of trust. <br />Dated: 7- 03 -- <br />Mortgagor/Trustor <br />Dated <br />State of Nebraska <br />County of HAMILTON <br />Mortgagor /Trustor <br />The foregoing instrument was acknowledged before me this 19th day of May, 2003 <br />by LOIS F. NIELSEN A SINGLE PERSON <br />GENERAL NOTARY-State of NebraSka <br />RITA E. PETERSEN My commission ex i es: <br />My Comm. Exp. Sept. 30, 2004 <br />mom 'OE 'ldag bx3 UU103 A" _ Notary Public <br />NEISU7319d 'A tf.1.IM I�� <br />"sejgenl ,o a;e'.; J, i "' 7 1VY -IN39 <br />C 1987 Bankers Systems, Inc., St. Cloud, MN Form DRDH- LAZ -NE 3/8/2001 (page 1 of 1 ) <br />