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<br />IN WITNESS WHEREOF, Grantor, on the day and year first above written, has caused this instl11ll1ent to be
<br />sipedand sealed on Grantor's behalf by .the undersigned employee, being ther.eunto ?u~y~ppoipte,<l" qulll~~f
<br />and acting pursuant to title 38, United States Code, sections 212 and 1820 and tItle 38, Code of Federal
<br />Regulations,. sections 36.4342 and 36.4520, pursuant thereto, as amended, and who isauthorizedtoexeclltethill'
<br />instrument,
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<br />Si~iSiW.ED~DEtlvm:D IN PREsENCEOF-,
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<br />The Aimt ISh: to7()fV~e_Affai7Sf0f?!"~: ' <.
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<br />VA Regional Office, Lincoln,NE
<br />Telephone: (402) 471-5032
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<br />(Pursuant to a delegation of authorio/ contair.edin
<br />VA Regulations, 38 C.F.R. 36.4342 and 36.4520.)
<br />
<br />STATE OF NEBRASKA J
<br />88:
<br />County of ....~E~~~~~..................__...
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<br />On this date, before me, a notary public in and for said County, personally came the above named ....m"___
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<br />....___.l~~~..S;.:..Ji!n..l.:!h__.............,__........"."....,"____,.....'."..,..."..,......__....._._._._.__ _ an
<br />employee of the Veterans Aaministration, an agency of the United States Gove~m~;;t:.si;~;~d..~~~e;.~f the
<br />foregoing Instrument, and acknowledged the same to be his/her free act and deed on behalf of the Administrator
<br />of Veterans Affairs.
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<br />In witness whereof, 1 hereunto set my hand and official seal this the ...~:!.t..h.m____ day of __~.!l..&.~1!:.._.___..__.._.
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<br />N ow,1'l/ Public.
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<br />"- *Note- Print, typewrite, or stamp name of the employee executing this instrument~ and also names of witnesses and notary public
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