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<br /> NEBR•UCC UNIFORh7 COMMC���AL COOE t�aftn�rt zn0 kttCn�Wolf,wz!i:r_Nr�?�it �
<br /> Form 5(1 $iA7EMEj17S OF COYTIHlUAT101Y, PARTIAI. iiELEASE, ASSIQYMGNT, ETC.
<br /> _..�.-
<br /> IkSTRUCTIONS
<br /> 1. PLEAS6 TVPE thit form.
<br /> 2. R�mo�e S�curM puty �na Oeo[or cna�as a+W sena otner � eoa�n w�cn �n�erUav�d carban paQt� �o ;na tilinq atticn.
<br /> �. Enelos�tilinq fHltl. �nd flll m onqm�l F�runtmq 4tattmmt numbtr soa O�n tiltd. •
<br /> L. If ttfi tp:eo Ptovi�:d tor :ny icemisl an �ne form �s ��ade4uere the itemla! lhouid�r s�t�rtued on edd�[toml �I»eq. 6rtft�NY.y 6"M 8"er 8"x 10"•
<br /> OMy Ont toDY of fueh idtlinoMl th�stf n*td D� �etzanietl to t�� filinq offittr w�tn o sQt o4 Ihrt� eoD+es of ttcia (UM- lMq cChldul�s of
<br /> eolt�coeal. �cc.. msV O� on any s�sa WP�r th�l iti cqnvement �or �h�ieeu�a� partY. Incfiot� �he numbrr ot+ddiaan�l rnt�n �ttsched.
<br /> 5. tf�p0y2ba�i� aopl or ppo0s wAich �n or �n ro b�cam� fixtura.Orssnt�Q�mr�lry Ntu real atrt� ��1 9�w nam� of neorQ owner.�
<br /> 8. At Ne tim�n! filina. tilina oftictr wdl �ttum Ihntl tdpV +N�� �Ck�ow7adq�mMt.
<br /> T1�n STATEMENT a prrsmrcd �o a liling olficv for libng purtwnt to th�Undorm Comrtcatewl CGOo: + 3.M1�aturiry dAN (i1 u+yl: _
<br /> 1.Oeb[alfl {Late Nun� F�ntl and sddressf�s! Y.Seeure0 Pirryliesl md �dtlr�sylesl PtN F�ling Olficnr i0in. Tim� �nd Fiitng
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<br /> Fxank Smratny Northwee�ern Public Service
<br /> 206 S. Wafnwrigh� 57.5 West 3rd "
<br /> Gran� Zsland, Nebraska Grand Ialand, Nebrasbca �
<br /> I.TN�s sac�mmt nt�n to a�yin�l Fin�cin9 Sattment Wsmg Fi1� No.. -93-1Q1�,�] .
<br /> Fi,,d �;,,,_Rec�iater of Deeda :p,,. F,�.� Jsilv„],�. �e_9,3_ ��
<br /> 5.❑ ComNw�tae. Th�oriymal finsneinq�t�t�mM+e b�tw�en �h� fwpoin9 OWror xM SM.trnd pKtv.W�nna li�f nurtlbN 4h6wA a110W. �� �tdl �ttatw�.
<br /> 0.$xTwT+n�nee. SKw�d w►tv rto ionqer ei+in++ � seeur��y ioc«nt unda th� tinu�cinq ecaurtN+tt Oeu�nq fil� nump�r �howa Wow.
<br /> � n w� TA�uw.u�rl�a�w•� riehr uM�� M� fit�aeteim statem�nt Msnnq lil� numbtt 1hCwn�hOr! IO tM pt00f►tV d�fClilHd �O I[M1 1�h�W _.
<br /> •� " • bMf�iti7qnid IO IG! WI�'IH WROf1 A7rtV �t1d idtlff3f�OOf7t! ill IItrt1 �Q.
<br /> _ d,❑ Amv,�fm�nt. F�nmc,ey Sut�m�++t bt�nng fite numOer thown �bdve is am�ndw a�ue Eam �n Imm 10.
<br /> 9.[] RN�t. �� Pxri �W�� �ht collnn�l aescr�bed �n Item 10 �rom Ih� Hnsne�ng srnemrnt badn9 lu� nu�+b�r �howa sbow. --
<br /> 10.
<br /> Lot 5 V�11a Mar Dee Subdivi.dion
<br /> No.or �dditiona� SAa�tf� wes�nted:
<br /> � NorthwesLern Public Service Gom�anv
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