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�� <br />� <br />� <br />N � <br />0 � <br />� �� <br />� � <br />Q <br />O <br />B <br />� <br />M <br />� � <br />� � <br />� o <br />� � <br />� � <br />� � <br />0 - � <br />� r � � <br />� _- � r � <br />� � � <br />�� <br />� � � <br />�al � <br />� <br />� <br />State of Nebraska <br />�O <br />e77 <br />C <br />� A � <br />� �A � <br />. Y <br />-,..., <br />��� <br />r1 r : �>:' �--� <br />_ � -'- . <br />� <br />A� r � �� <br />� � � <br />z � � <br />o � � °^% <br />r' ; � <br />Ch ` F`- <br />� <br />'�t ` � <br />i r*� ' 'v <br />C'1 ), _ � <br />� <br />2 01101$ �. �. <br />c � ; <br />� --+ <br />c n <br />s --� <br />--1 f'r' <br />� C <br />o �i <br />-*, _ ,. <br />.T r : <br />2�- C:a <br />r �n <br />r x> <br />U"> <br />� <br />2�- <br />C/j <br />� <br />Space Above This Line For Recording Data <br />DISCLAIMER OF RIGHT TO DESIGNATE HOMESTEAD <br />Each of the undersigned states as follows: <br />Non-Homestead <br />O <br />N <br />O <br />►---• <br />H <br />O <br />� <br />� <br />F--.+ <br />1�-+ <br />� I intend to grant a security interest in real property legally described on the attached mortgage or deed of <br />trust. No part of my homestead is presently situated on said real estate, nor will any of my homestead be <br />situated on said property in the future. However, if I establish a homestead on any part of said reaf estate <br />during the time the mortgage or deed of trust remains unsatisfied and is a lien upon the real estate, I will have <br />no right to make a designation of homestead in the event of a foreclosure or trustee's sale upon such mortgage <br />or deed of trust. <br />Homestead <br />❑ I intend to grant a security interest in real property legally described on the attached mortgage or deed of <br />trust. My homestead is located on said real estate, and I understand I have the right to make a designation of <br />homestead in the mortgage or deed of trust. If I waive or disclaim the right to designate my homestead I am <br />waiving rights, that I would otherwise have, to retain my homestead in the event of default upon such <br />mortgage or desd of trust. I hereby waive and disclaim the right to designate my homestead. <br />I have read the paragraph checked above, and I understand the contents of that paragraph. <br />This disclaimer was signed before execution of the mortgage or deed of trust. <br />Dated: � //��,-� /� <br />Mortgagor/Trustor <br />Jason R. Bupsack; alkla Jason Bonsack <br />Dated: �,il/Ic.— /� _ � +�J,�� 'la- ��t�.�� <br />State of Nebraska Danielle M. Bansack Mortgagor/Trustor <br />County of <br />The foregoing instrument was acknowledged before me this �day o G'�� , ��� <br />by Jason R. Bonsack: Danielle M. Bonsack; alkla Jason Bonsack <br />(Seap <br />GfJrERAL NOTARY - Sfate of Nebraska <br />JANICE K BOEHLE <br />My Comm. E�. hNardi 27, 2013 <br />My commission expires: 3� Z-7 �� `� <br />Notary Public <br />✓ <br />S <br />� OO 1987 Bankers Systems, Inc., St. Cloud, MN Form DRDH-LAZ-NE 3/8/2007 /page 1 of 11 <br />