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<br />.200702602
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<br />INSTRUCTIONS:
<br />
<br />READ THIS ENTIRE DOCUMENT BEFORE SIGNING. If any statement is not accurate,
<br />insert a note directing attention to the reverse side and set forth an accurate statement on the
<br />reVeIse side, and NOTIFY THE TITLE COMPANY OF ANY ADDmONS PRIOR TO
<br />CLOSING.
<br />
<br />RESIDENTIAL AFFIDA VlT
<br />
<br />STATE OF Nebraska
<br />COUNTY OF
<br />
<br />FILE NUMBER 07.2278
<br />
<br />III order to :induce Old Republic National Title Insurance COlnJl'lny to :issue its policy of title insurance on the property
<br />legally described as:
<br />Lot Eleven (11), Block C, Parkview Subdivision, city of Grand Island, Bali County, Nebraska
<br />
<br />with ,an address of , Nebraska, the undersigned, hereiuafter referred to l\Il affiant (whetheI one or more), of lawful age,
<br />being first duly sworn upon oath, states to the best of affiant's knowledge that:
<br />
<br />1.
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<br />Affiant has owned the described property exclusively and continuously for more than &ix months immediately
<br />preceding the date hereof.
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<br />2.
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<br />The property :is located :in a platted subdivision and that there is located thereon a single-family dwelling which
<br />has been completed for at least sixmonths.
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<br />No 0IlC is :in possession of said property other than the affiant, ew:pt (if none, state "None').
<br />
<br />3.
<br />
<br />4.
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<br />There are no unrecorded contracts, leases, easements, agreements, documents. or notices of claims relating to the
<br />property, other than (if none, state "None"),
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<br />There are no unpaid bills for labor, services or materials for construction of improvements. alterations or repairs
<br />to the property dur:ing the last six months.
<br />
<br />There has been no work :in the immediate vicinity :in the last six months for matters such as: grading, repairing or
<br />paviog of street-q or sidewalks; installation of repair of sewer, water or electrical line; installation of street Jights;
<br />etc.
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<br />5.
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<br />6.
<br />
<br />7.
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<br />The affiant has received no notices of future public improvements which might result :in special assessments or
<br />charges against the property.
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<br />The affiant has not been notified of any violations of local setback or building restriction regulations.
<br />
<br />8.
<br />9.
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<br />Therc have been no disputes with neighbors over fence or boundary lines, driveways, walks, street or alley locations,
<br />encroachments of buildings or improvements, or violations of covenants and restrictions.
<br />
<br />10.
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<br />The affiant has no knowledge of any underground pipllS, cables, conduits, ditches or drain tiles crossing the
<br />property.
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<br />There arc no poles, wires or lines crossing thll property which servll other property.
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<br />Therll are no shared driveways or party walls except (if none, state "None'?
<br />
<br />11.
<br />
<br />12.
<br />13.
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<br />There are no encroachments of buildings, eavell, bay windows, walks, fences, drives, etc., from the property of the
<br />affiant onto adjoining property (including streets and alleys), or onto easements or setbacks, nor are there such
<br />encroachments of adjoining property improvements onto the affiant's property.
<br />
<br />14.
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<br />There are no unpaid tllXe.~, assessments, water and sewer bills or homeowners association dues.
<br />
<br />15.
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<br />There are no marriagll dissolution, probate, conservatorship or guardianship proceedings, tax liens, bankruptcies,
<br />pend:ing lawsuits or unsatisfied judgments of record, :in any court, State or Federal, against thll affiant. Any such
<br />matters appearing against' similar names are not against the affiant.
<br />
<br />Dated tbis J.~. day of 1-1 tv c h
<br />
<br />2007 ~ \
<br />y '\w.W~
<br />LESLIE EANWESTO
<br />~wl;1- ~V1'/
<br />
<br />Sub"",,,' 10'" """" bofure = 29" day of n~ ~ ~
<br />
<br />~ r~ N
<br />.~, NotaryPU: lie .
<br />~'C."'.;...,.. "'1' ~-'" A--r 7.70 I 0
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<br />Pag.1
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<br />Form SOftWare by Automated RIUII ~. SIII"JkIe&,lha. 1....u0-330..1:26
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<br />07-=a f
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