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t <br />~ Cirtifisote of Canveyanc~ offer tifon Dseds of Reat Eswre <br />~' ~ <br />I ~~„+' ~~ !~ ~'~$ <br />~~ ;i <br />Tfiis Statement is Coniidentiai and Available <br />to Toxing Qfficiols (]nly <br />i'his form pursuant to Section 76-214 R.R.S., 1943, as amended by the 75th Session of .he Nebraska <br />Legislature, must be completed and attached to every mortgage or other conveyance of real estate <br />tseept dteds o(-tal estatt before such instrument is filed for recording. <br />Parties to Enstrument...?~?'?7. S~. Adamss..Barbara J..Adama~,t,&. f:IT.Fiasneial,Sergipea_,_,~t;et..,. <br />Type of to%[rUment , Itea1 Property T~tort.~a~e. Date ~Of ??/~~ .... Book ............ Page <br />Gorrsidefatiofl paid 1vr Real Estate .............'...:........ s aow.w <br />"~'"' Certificotion <br />"? <br />j ~~~~~t, the u~~nders,i,gned,:,,,having porse7mal knavelerige of thin, transact ton, eenttfy~ 1.3rat the t~urc,gt~7~ing, is true <br />G'If.'Y~nd correct. ~° ~.~_. <br />-~ <br />Signature ,... <br />I i <br /> <br /> <br />