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� . . � Appendix A-35a <br />�� <br />_ <br />� `� � � � a <br />� � ''� � e� r � � � m <br />� c � fi � _ � r' � <br />N � � . � 1'n 4 " �. p ' � � O <br />0� � � � �� � z�P� � �I <br />� � t-,-� <br />c ,n v m <br />rn <br />0 - � ' - . � = N \ � • � O � � � <br />00 � . � ~ O z � � � <br />N � � • � � � � � � z rn � a� � C.�9� <br />� Q � ; ; Z7 . � � '°� � � <br />� . Q 3 F- T> � �-"' � <br />� �` . � � iCd � � <br />�� � � p � Z <br />� , ti,, �... oo —I <br />.. r .�� . . � � 0 .1•,� O Z <br />� . . � <br />v <br />� �(e6ras�a � . ` Af�davit of �.ffixt.ure . � <br />. <br />}� ,/� �/�� For a MQbile Home Wi�h � a � � <br />- �� ��� J���///�� . , :: <br />. t:� .: . <br />Departrrtent of Motor Vetiicles . N��X's`�S�a �.e�'�1fl�a�E' Of T1tlC :. : :- <br />Written consent for r��ease of ]ien anil cancella.tion�of Certi�cate of Title �from each lien holder must be attached to th2s, <br />Affidavit. This . completed Affidavit . mttst be presented to. the Desigriated County Q�fieial, a}ong with the -Certificate of ` <br />Title, ir� the c:ount}± where the �ertiftcate of Title was .issued for cancellation of the e�tisting Certif cate of Title to occur. <br />A fiting fee is: required per: §33-109 and §33-112: <br />Mobile �I me Owner #1 �VIobile Hotn n r�#2 <br />Na�ns_,es<�.�� �, „ � ,. -1 t N2trme �Ei��-�'�[fi-- !�� �`'� <br />� � ddress `7"� �4J� �� l�Y �+�. l�'�` Address , � <br />C,--� .-�- .- . <br />..�ty, Sta�e Zip. �..YT.� L..f Yi'tly"�, /v� li7 �� /� Ctty, State.Zip � <br />� Attach additional Aftidavi!(s) if more than 2 owners. <br />i • <br />� er of rea� esEa#e � Leasin real estate <br />Mobile Heme Description: Year �ake - �' Modei <br />Vehicle Identification Number (r � �✓� � � �/ V Title Numt3er . � O` � "� � <br />� � � � <br />If hvo Vehicle Identifcation Numbers are.preset�t, an Affidavit mus.t be com.pleted:foreach.number. <br />Real Est�te Owner #1 <br />� 3�a�e . <br />� Acldress 7 � � � �� ��I�`-t/�� . <br />' City, State, Zip � �� . �� � �Q � <br />Attach additional Alfidavit s if mo� <br />Real Estate Owner #2 <br />Name. �Tl+a�� �J;�!-lYtt�. <br />Address � � /� <br />City, State, Zip �• /'�' ��� � %� <br />Copy, of Notice of Cancellation shall"be provided to all owners Iisted abov.e and the fallowuig #"inancial instituti.on(s): <br />Name. ' - Name . <br />Address Address . <br />\ r � <br />.ry, State, Zi� City, State, Zip <br />� Attach additional Affidavit(s)_ if more than 2 entities are to be notified ' <br />1 of 3 <br />_ Aifidavit of Affrxnlre For a Mobile Home With a Nebraska Certificate of Titte SC2006 <br />