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� 20110258G 5. MASTER FORM. By the delivery and execution of this Security Instrument, Trustor agrees that all provisions and sections of the master form Deed of Trust (Master Form), inclusive, dated ...........0$�R7/2Q0.7............ and recorded as Recording Number ..................................... or Instrument Number ..�PQ70774�...................... in Book ............................................................. a't Page(s) .................. of the Official Records in the Of�ce of the Register of Deeds of .. H/A�1, ........................... County, Nebraska, are hereby incorporated into, and shall govem, this Security Instrument. This Security Instrument will be offered for record in the same county in which the Master Form was recorded. 6. ❑ CONSTRUCTION LOAfV. This Security Instrument is a construction security interest which secures an obligation incurred for the construction of an improvement on the Properry. 7. OTHER TERMS. � Mortgage Rider - Escrow for Taxes and fnsurance. If checked, the covenants and agreements of the Mortgage Rider - Escrow for Taxes and Insurance is incorporated into and supplement and amend the terms of this Security Instrument. SIGNATURES: By signing below, Trustor agrees to the terms and covenants contained in this Security Instrument and in any attachments. Trustor also acknowledges receipt of a copy of this Security Instrument on the date stated on page 1 and a copy of the provisions contained in the previously recorded Master Form. . �,G44.i�4a��! y .�Q�e�+�:GC��.:�� ................. � / (Sgnanue) �.AVERN L LEWANDOWSKI (Date) �-�� 1 ......C<-�!... C,l��z��......... (Signature) CAROLYN LEWANDOWSKI (Da�) �-- lJ-- lf ACKNOWLEDGMENT�� /�� STATE .... ........................................... COUNTY OF .... k.. ...........................................} ss. - ��a��a�� instrument was acknowled ed before me this ............... �4�� g . . . � day of . . . . . . . . . . . . . . .. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . by ..LAY�RN.l..1,�1.N.ANpOVY.SKI and CARAI,Y. N.I,�W..ANROW.S.KI,, H.u�4and. and �lYife. ..................... ........................................................... My commission expires: ,(�.-�/ � — Z�I � ............................................................................. . ........�� .................................. r-- (Notary Public) GEr1ERAL NOTARY - State of Nebraska OONNA M. MICEK My Comm. Exp. June 18, 2012 �7994 Wolters Kluwer financial5ervices- Bankers Systems TM Form USBREDTSFNE 9/14/2009 (page 3 of3)