Laserfiche WebLink
�0�1063�5 <br />IN WITNESS WHEREOF, Homeowner(s1 has executed this Affidavit in my presence and in the <br />prese e of the�ndersigned witnesses on this �_ day of <br />_�, /.7 l - � , �_ . <br />, �c/ � , (�_p� . _ <br />L�,Q L]. Y Y,Y1 Q 11 <br />Homeowner #1 {SEAL► Witness <br />I�ISEA M HILTNER <br />Homeowner #2 tSEAL) <br />Homeowner #3 (SEAL) <br />Homeowner #4 (SEAL► <br />STATE OF �1VP�b�(ti,� <br />COUNTY OF <br />Witness <br />�tness <br />Wimess <br />! <br />) , ss.. <br />) <br />On the � day of ` � in the year � <br />ne, th� undersigr�ed, a�Jot�.ry Public in and r said State, personally appeared <br />personally known #o me or proved to me on the basis of satisfactory evidence to be the individualis► <br />whose name(s) islare) subscribed to the within instrument and acknowfedged to me that <br />he/she/they executed the same in his/herltheir capacity{ies�, and that by his/her/their signature{s1 on <br />the instrument, the individual(s1, or the person on behalf of which the individual(s) acted, executed <br />the instrument. <br />otar Signature <br />Notary Public, State of r j� <br />My Commission expires: �-�—�_ j <br />Official Seal: GEPIERALNOTARY-StateofNebraska <br />EUZABETti A CiARDUNO <br />MyComm. Exp, h4arct� 2, 20t3 <br />�1 �� ���'h �" - �2`�lv r�d <br />Notary Printed Name <br />Qualified in the County of j <br />ATTENTION COUNTY CLERK: This instrument covers goods that are or ere to become fixtures.on the Land described herein <br />and is to be filed for record in the records where conveyances of real estate are recorded. <br />Page 4 <br />NMFI # 7111 (MAHA) Rev 2/4/2008 <br />