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ccc -297 (08-18-04) 2 0110 8 9 8 5 Page 2 of 2 IN WITNESS WHEREOF, the undersigned parties ereto have executed this instrument this (h) �� =� day of (i) � � � � 4 + 342 , (j) � � (year). if a corporation: (k) Name of Corporate (Mortgagee) (Owner) * � .� r+ /�.,w►�e-�?i C.. T b�'a�w�, La�-.,�Za�i� �ITH � KSO � L n TD �� FA � M � ILY PARTNERS P(OWNER) � J�fl.++tA.C� /Y�YV�d►r" By HINKSON BROTHERS ( �� W �� "" " (l) Dul Authorized O acer ` � Y .ff fZl,��,��✓�0�� C (m) Title CORPORATE SEAL "Mortgagee" includes holder of any type of real estate lien. *Delete "Mortgagee" or "Owner." (p) STATE OF (� `�'6i��iGq� (c� COUNTY OF l� L.� } ss. ACKNOWLEDGMENT: n �h On this (r) ��"` ' day of (s) cJ J 6u-3£2. in the yeaz (t) � 1 � , before me, the undersigned, a Notary Public in and for said State, personally appeazed (u) IC� � t `L �� ► aKS� n1 ND � R��+�1 personally lmown to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is �� NILSa � (are) subscribed to the within instrument and aclaiowledged to me that he/she executed the same in his/her/their capacity (ies), and that by his/her/their signature(s) on the instrument, the individual(s) or the person on behalf of which the individual(sl acted. execute the instrument. �SE�. - lL �� v> o� � �� � G�I�II I�rAIt1r-StaGeof I�Ska ; �iELLEY IL SPdlROfDER Nh►Cortun. Exp. �t S, 2p14 My commission expires (w) ((— ��'�.�'j —�' (MM-DD-YYYY) The /ollowing statement is mede in accordance with fhe Privacy Ad o11974 (5 USC 552a) and the Paperwork Reducfion Ad of 1995, as amendea'. The aufhoriry for requesting fhe /ollowing in/ormation is 7 CFR PaR 1436 and the Commodfty Credt Corporedon CharterAd, 5 USC 714 ek seq. The informaffon will be used to determine eligibUity for CCC financing /or /arm, storage arwl drying equipment. Fumishing the requesfedlnlorma6on is w/untary,� however, wifhout it CCC financing under fhe progiam cannof be provided. Failure to /umish the requested InlormaBon wi11 resuR in denia/ of CCC finanang under this progrem. This inlormaffon may be provided to other agenaes, IRS, Department of JusNc�e, oi other Sfate and Federel !aw enforcemsM agendes, and in response to a court magishate or adminisGetive MbunaL The provisions of crimina/ and avil /reud stetufes, including 18 USC 286, 287, 371, 641, 651, 1001; 15 USC 714m; and 3f USC 3729, may be app/lcable to the informadon provided. According to the Peperwork Reductlon Act o/ 1995, an agency may not �ndud or sponsor, and a person is nof required to respond to, a collection ol informadon unless it displays a velid OMB c+ontrol number. The valld OMB control number for thls lnformaBon col/ection is 0560-0204. Tha dme required to complete this 1MormeBon collection is estimated to average 15 minutes per response, (nduding the time for raviewtng instrucdons, sear�hing exisNng data sources, gefhering and maintain(ng the data needed, and compleHng and reviewing the col/ecHon ol fn/ormaHon. RETURN TH/S COMPLE7ED FORA9 TO YOUR COUNTY FSA OFFICE.