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, <br />4� <br />` � 4 <br />� � 201103524 <br />STATE OF NEBRASKA <br />HOW/4FiD COUNTY �. 5 �� <br />FILED FOR RECORD <br />MO DAY�� <br />AT O'CLOCK�M. RECOI�ED <br />IN BOOK�OF RECORD PA�E <br />�i('� �.Q _ I��� c�ununnr �c <br />State of Nebraska <br />CHG _______ <br />PAI D <br />FEE BOOK _.,.,.�..�.�..: <br />Space Above This Line For Recording Data <br />DISCLAIMER OF RI�HT TO DESIGNATE HOMESTEAD <br />Each of the undersigned states as follows: <br />Non-Homestead <br />❑ 1 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 real 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 deed 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 <br />Dated: �- � I � � � � <br />Dated: � � � � �� <br />State of Nebraska��� <br />County of <br />M <br />Carlotta Y. Hartman, aka <br />O <br />The foregoing instrument was acknowledged before me this 21st day ofA�ri1,2011 , <br />by Thomas L. Hartman akaThomas Hartman• Carlotta Y. Hartman aka Carlotta Hartman HUSBAND AND WIFE AS JOINT TENANTS <br />GENERAI. NOTAAY- State of Nebraska <br />JANICE K. BOEHLE <br />Nh' Comm. Exp. Mard� 27, 2013 <br />My co expires: � � � 2� �� <br />. <br />Notary ub ic <br />Fj(� � 1967 Bankers Syetems, Inc., St. Cla.id, MN Form DRDH-LAZ-NE 3!6/2001 (page � of 11 <br />