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2011011�2 <br />Appendix A-35c <br />Under penalty of law, the undersigned affirms that the information contained in this Affidavit of Affixture is true and conect and that <br />the above-described mobile home has been affixed.to the real property described above. The undersigned hereby aclrnowtedges that <br />this af�idavit is rnade with tl�e understanding that any person who misrepresents the information provided in this affidavit shail be <br />guilty of perjury, a Class III Felony. <br />All owners must sign and signatures must be notarized. <br />�- <br />L `m��,�,�- <br />Printed Nam Mobile H�te Q <br />/ i � � ' `� <br />� <br />Home Owner <br />State af �� � <br />County of _�, <br />The foregoing sigpature of the affiant was ackn wl� <br />before me this �� day of , 1 <br />N tary o Designated County Official � <br />6ENERAL NOTAR ebraska <br />JENNIFER L. KEOWN <br />My Comm. Exp. July 16, 2011. <br />Seal <br />1 � � � <br />� j� wf � �� .. � rrun.e�5.e`1/Gdt/� <br />Prmted Name o Mobile Ho wner <br />� �� <br />Si ature of Mobile Home Owner <br />State of ��?�J��' � <br />County of �/�L�� -� � <br />The foregoing signature of the affiant was acknowledgecl <br />before me this�2 day of ��� a <br />��G✓���7,i'�i12��2� <br />Notary or Designated Coeurty O�cial <br />GENERAL NOTARY • State of Nebraska <br />DIANE L. LAMON <br />�'" _ My Comm. Exp. Sept. 2, 2011 <br />Seal <br />3of3 <br />Affidavit of �xture For a Mobile Home With a Nebraska Certificate of Titte 5/2006 <br />