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B47 L14 G5-6d O r 0,36 W WASHINGTON COUNTY, STATE OF NEBRASKA Blair Cemetery ��i�� //, ,��// Blair NebraskaRECORDED` ATLL; jqjM, BOOK-. ,7� ®„PAGE(S) To whom it may concern -1 z e ry a-• Inad aew REGISTER OF DEEDS 2011 OCT I I AM 10' 4! 1WE N A. MADSEN WASHINGTON COUNTYREGISTER OF DEEP$ This is to inform you that the deed for the Grave Spaces 5,6 Lot No 14 In Block No. 47 owned by Niels and Natalie Carlsen will no longer include Natalie Carlsen since she passed away on August 24 at the Villages Hospital in Villages Fl. Since I am now living in Florida and all of my children live in Florida, I hereby pass the ownership of Grave Spaces 5,6 Lot No 14 in Block No. 47 Of the Blair Cemetery to David and Lois Carlsen. Sincerely, NEBRASKA DOCUMENTARY Date�STAMP TAX .�> 0 011/ ies . Carlsen STATE OFF"/(, r ZA 4 COUNTYOF A42tr The foregoing it : ;a — arr". -,19ed, bfore me this 3 day of who �IS�:r_ 2011 „� v�� i cis ri sfiaZ'�rlStn r "a nesproducedtL�.,d V1110sii0rues, 10Dtak � t , Cr�era"S�CHR1SiINARENNA®ELLAVANCEoab'�g_6 ��S ,gh Notary Public, State of Florida Notary Public Commission# 0868629 My comm. expires Mar. 11, 2013 Recorded General Numerical - - Photostat Proofed Scanned 1 16 0 Huffman and Felton &Wolf, Walton, Ne. 66461 10 -A—WARRANTY DEED 85 KNOW ALL MEN BY THESE PRESENTS: TIIAT I or We, Ruth Muchemore, a single person, , herein called the grantor whether one or more, in consideration of One Dollar and other valuable consideration -------------- received from grantee, do hereby grant, bargain, sell, convey and confirm unto The CiL-y of Blair herein called the grantee whether one or morn, lite following described real property in Washington County Nebraska Graves 11 and 12 in Lot 9, Block 43 in the Blair Cemetery, Washington County, Nebraska. To have and to hold the above described premises together with all tenements, hereditanumts and appur- tenances thereto belonging unto the grantee and to grnnlec's heirs and assigns forever. And the grantor docs hereby covenant will the grantee and with grantee's heirs and assigns that grantor is lawfully seised of said premises; Ibat they are lice from e[ell III brance that grantor has good right and lav:fti authority to convoy the same; and that grantor warrants and will defend tile. title to said premises against. the lawful elainns of all persons whomsoever. Dated December 1 � l!I 88 t Ruth Muchemore .................................................................................................... State of ...Nebrasjca,........... County of'UC frf The foregoing instrument was acknowledged before me on ... A���PIi?.�...I..vS....r..1988........ by...... Ruk.h.X14rhamQx.Q ................................................ .................. ,................. ..............- tll rv'. ;..4-.......... Notary Public i�Mt IF Mlf,SbY N Yoga STATE Oj+ . /. �4 :�!-.44'.<^.E: �-� ..........: � FRANK 0. DESS County i:J `t C`"' ... My Comm. Exp. Aut 1. 1991 / ' 1 ' d f1 d f • I ' tl R i t f D ed Offi of said Count the Entered on nutnettca to ex an u t e or recox ut to eg s er o e s ce y +:....... day of. t:C �.�•:iti J.., 19.. ��.�at...... ��...o'clock and... 3.U....minutes .. �......M., i and recorded in Booh...... �:, �.......... of... � Nr�* ....at page... �. . li //1/ Reg. of Deeds (' 13y 44- '..VLKoq.4 �: ....... Deputy !� DEC 2 7 1988, r'Y j $r QYZLw . I l l k cb,-c/s c�qc� /r�<:flt lama/ -ate nioto5tat --- 78-A —QUIT CLAIM DEED - - a Hultman and Felton 8 Wolf, Walton, Ne. 68461 ��- --- E, Madeosnnd THIS INDENTURE, this �� day of in ar the year one lhn No�ev" bzv nine hundred and eighty eight , buhvicen i Mary Bottolfson i I I of the first part, and Ruth Muchemore of (he second part. WITNESSETH, that the said party of the first part, in cn tAdendion of lite sum of One dollar and other valuable consideration--------------------DOLLARS, "— to -duly paid, the receipt whereof is hereby acknowledged remised, released, and quitclaimed, and by these presents do remise, release and forever quitclaim unto the said party of the second part, and -to-h(s; herar thelr heirs and assigns forever, ,It his, her or their right, title and interest, in and to all Graves 11 and 12 in Lot 9, Block 43 in the Blair Cemetery, Washington County, Nebraska. — Together with all and singular the h-edilamenis thereunto helongiug. i, TO HAVE AND TO HOLD the above described premises unto the said grantee and to gnuuee'.v heirs and .signs Gm•ver so that neither the said greater , nor any person fn his, her or their name and behalf, short or will hereafter claim or dem;uul nay right or title to the said promises or any part thereof, but they and every one of them shall by these presents be excluded and I� forever barred. ""'Mary"'Bb' 'tdI'f'son .......... . ...._.................................................................................._.................. OFFIC L SEAL. .................................... ................................................................ o. .........f..IORRAINE.BRAClf..."..I....".........".... NOTARY PUBLIC • CALIFORNIA ............' ;y.N , S2ftT&VARA.COUNTY............................. ............................................................................................................ tAy comm. expires SEP 29, 1989 STATE OF............ I .1.%d/.?.f%1L4, County of... ,.fA.T/.i:....(��119/.0.......: Before me, a notary public qualified for said county, personally came Mary Bottolfson known to me to be the Identical person or persons who signed the foregoing instrument and acknowledged the execution thereof to be his, her or their voluntary act and deed. Witness my hand and Cnotarial seal on.......Gk..laL>.fy�il.�.Q.�.-••..•• ........ 19...iF...� My commission fres:....CY. r!.._7�............ 19.p.l. Lfi..•.....•e�r•<l�fl1-fit% yJ •.. .--... otary Public. -. STATE • ......................... ......./^... _ l ` Entered on numericalti ex and filed for record County . ................. ....C..C..Ckbl..... .................. 1} in the Register of I)ceds Olitco of anal o the , .. H/ ..-.f.......day o£.. // _ -., 19... . at..........................o'clock qaand...........:V............minutes .......... � M., and recorded in Back...............l. .a... .........of......1.. ... ...at p/�af/%,o�....—r? ................�......... ��------ ...... .?n .v..t`�..C.,.4�- .......:Reg, of Deeds By..:�«!-..�c� .............................. poly nnorhd ( NOV 2 9 1988 General thl nefical ------ $ O O r Cl QY Photostat 21919-- - - - -- - ------ -. 'I WITH REGv Estate r ns r� TO BE FILED Read �$t1 a JI �1 5�7 ter Vtatement ASTER This Statement is Confidential ifor�tax Officials Only 521 OF DEET S • Read ingtroctions on reverse side • THE DEED WILL NOT BE RECORDED UNLESS'THIS STATEMENT IS SIGNED AND LINES 1 TIRI OUGii 19'ARE,PROPERLY COMPLETED • COUNTY.ASSESSOR'S USE ONLY County Name County No. Sales No. Location I.D. i Ai b ?;a '? Vol Ir luu Iierlt PropertyType `lelaiamll•u;� 4 C� mrrie�clal'(j���r1:; i. :�� iiia zttfl i �,ir ��! ,1F_li „tra cultural (Total O ❑,!� g Y O [� P 0 of Acres 1 if (2) ❑• Multi. Family ! .,'.(5) ❑1ndusirial'ti , (a)'❑ Mineral Interests 1 Date of Sale 2 Date of Deed i �r>iri ",,3;ttr a! Recreational 9 Other % !/" pe `� Year }' Month f '� Day Year (3) ❑ Home Sites (6) ❑ cabins etc. () ❑ Month 3 ; ,Grantor's Name, Address, and Telephone 4 Grantee's Name, Address, and Telephone Grantor's Name Nam e (Seller) Grantee's Name Buyer) Bottolfl�son Ruth Buyer) ss Street or Other. Mallin Address s i streel�.or�O eSOUQ hra85th state s ' „I t ti' i i,, , 1210"` Old pie �%ansh`Carie " "� ` e zip coda city state zip codeCity 68114 San iJose Ca..;,, , 95120 a P0mhha asks Nebr ,; Telephone h Number Telephone Number 6 Type of Deed 5 Federal Employ r, Identification or Social Security Number tType f ed of Grantee(s) (Ii more than two, attach list) Ruth '506" "0970 ,u 7 Type of Transfer {{ ,€t'fu s,+�. Irl { ,;, ';tit ❑, Sale la1H I�1 Exchange ❑ Foreclosure ❑ Satisfaction of Contract ❑ Other (explain) 8 Ownership Transferred in Full (it, no, explain) 9 Was sale between relatives? (if yes state relationship) CjCYES ❑ NO ! I ❑YES ❑'NO NO , 11 Was mortgage assumed? (if yes; state amount and intereet rate) 0/0 10 If the real estate was transferred for nominal ❑ ES [ NO $ consideration, what is the current market value? 12 Does this conveyance divide a current 13Was sale through areal estate agent?;; 14Was real estate purchased for same use? (if no` explain) parcel of land? ❑YES C� NO ❑ ,YES i� NO Cit68008 Zip Q 0 ode State 6 $ 15 Address of Property �� �! "`' i �" ' N - B.ai ebraska 16 Legal Description Graves 11 and 12 in Lot 91Block 43 in th® Blair Cemetery W $l►i�4t'r4�,t l St, , j ;lit I it, 0 ,i l; a,, 61711 , :00 7 hase pilce including bllitiesased, ••• 17 Totalpa l,�ir;, , rty`ir�Cjuded!(n'purchese? ❑Yes ❑'NoIf `;res,i0 100 eiifer amount and attach Itemized list) 18 Was noxi teal ro , tr t1, i 19 Adjusted purchase price paid for real estate (line 17 minu§ line i8)'. I.i: .. 19 $ i 00 under penalties of penury I declare that I have examined this statement and that it Ist to the bttofmy krib4rledde and'bellef, J i,l ' 1<'tilli,i true and correct, and that I am duly authorized to sign this statement / • r li tat liii.�l �xly 7.uti)ti'� 1". 9.,�li;a tiT €?I t� sighs �Itti iiw�t � tt`ly•w*iii �iuU��f,,,<;r. .f l��,u�,t.c,�t,,b �, alt>{res � bvittnii h le .r �rl .r�l_lri:,nl bluinr lir?,�1, ts, � i•, 1 i ,i ;tt�I Date;. here Signature 1 ttiTitle> I; lyi;t„t nnsl lii,ri ,lrltr;l�� Iiui, , Year ,- h,,�,;REGISTEROF. DEEDS' USE ONLY 23 Deed Page 20 Date De Recorded L 21 Value of Siam r Ex m/ptINumberki.,? 229 c4 Deed Book Month �/ Day_—! p v ��'�-C h �..f �,u �ti,fti I tF,)'i,' :'ii =.1f =iJi 311i= COUNTY ASSESSOR'S USE ONLY Y8 . Agricultural Land 24 .�, ? s .Parcel sioIdentification Township Section Quar. Subdivision Block Parcel Number,,i.{ • i i,r LVG i �, No. of Acres LVG .:No: of Acres 1 _C11 „ 25 h, -.I; t kn,t�l „ Improved Parcels Adi w) 1 f tt ui;tr(I St Height Arch TYPe-la,ili;� Q� Crpde CC qualily of NO -,91S 4 Rte efii ry� Floor Area Basement Finish 1. It!?iitliJ.�t ,di 11ft;moi Garage Stall ": Garage Type Year Built Modernization/Rehab L i�lt,»i ri b,:1, 'jd) ;iioj 'sill vi Miscellaneous RCN If fi4 .1 ,.! OU,� perating Irr. Te Total Acres/Lots DepraFiation, S❑tu YES! ❑ NO a 9 ?Viand adjoin curfent o YP Re e n No Doe , Miscellaneous_,., I unit „ ❑ YES'}' ❑ NO';. 26 Platted Lots Zoning Irre Front Deptf) 1 :! , �i 29 $ 100 g' ii, 1 .>t ,a+('i' 29 La6d WOO i� c, lit a, Site Improvement ' '''7,i .7 ', i;i;ilii o ` 100 Lot Size " N "` i" ' Street Improvemen P •rt.�. a i >Q_i �,,l,i? ,,�„i ,.:iii ,j.:l,�i> , .30 ITiprovement value ,, 30 $. •- i 27Should this sale be used in an assessment/salea. I:If no, 'give nonuseable sales code 31 Total value (line 29 plus 31 $ i00 ratio study? ❑ YES ❑ NO.'.,'line 30 Nebraska Department of Revenue Form No. 2-146-67- Rev."10-85 Authorized by Section 76-214, 77-1327, 77-1328 fl.R.S. 1943 Supersedes 2-146-67 Rev. 11-79 COUNTY ASSESSOR — White and Canary Copies NEBRASKA DEPARTMENT OF REVENUE — Pink Copy GRANTEE — Goldenrod Copy