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- PR OPERTY
(1) L] Single Family
(4) U Industrial
Pro z
(1)L] Improved
(1) L] Single Family
(4) U Industrial
(6) Lf Recreational (d) ❑ Mineral Interests- (9) ❑ State Assessed
(1) ❑ Mobile Home
(2)❑ Unimproved
(2)❑ Multi - Family
(5) ❑ Agricultural
(7) ❑ Mineral Interests- Producing (10) ❑ Exempt
(3)❑ IOLL
(3)❑ Commercial
Nonproducing
8 Type of Deed
❑ Warranty
F-1 Sheriff
F] Executor
❑ Mineral ❑ Cemetery
❑ Quit Claim
❑ Conservator
❑ Partition
❑ Trust ❑ Other
10 Type of Transfer
❑ Sale ❑
Auction ❑ Gift
n Exchanae
❑ Foreclosure ❑ Satisfaction of Contract ❑ Life Estate ❑ Other (exolain)
11 Ownership Transferred in Full (if No, explain division) 12 Was real estate purchased for same use? (if No, state intended use)
❑ YES ❑ NO ❑ YES ❑ NO
13 Was sale between relatives? (If Yes, check appropriate box)
❑ YES ❑ NO ❑ Spouse ❑ Parents and Child ❑ Family Corporation or Partnership
❑ Grandparents and Grandchild ❑ Brothers and Sisters ❑ Aunt or Uncle to Niece or Nephew ❑ Other
141f the real estate was transferred for nominal consideration, what is the current market 13 Was mortgage assumed? If Yes, state amount and interest rate,
value? ❑ YES ❑ NO $ %
Does this conveyance divide a current parcel of land? 17
❑ YES ❑NO DYES ❑ NO
Was sale through a real estate agent? (if Yes, name of agent)
13 Address of Property 19 Name and Address of Person to Whom Tax Statement Should be Sent
20 Legal Description
21 If agricultural, list total number of acres
22 Total purchase price, including any liabilities assumed .............. ............................... 22 $
23 Was nonreal property included in purchase? ❑ YES ❑ NO (if Yes, enter amount and attach itemized list) .. 23
24 Adjusted purchase price paid for real estate (line 22 minus line 23) .... ...............................
Under penalties of lave, I declare that I have examined this statement and that it is, to the best of my knowledge and belief, true
and correct, and that I am duly authorized to sign this statement.
2S -
Print or Type Name of Grantee or Authorized Representative
sign
h are V Signature of Grantee or Authorized Representative Title
Telephone Number
a
REGISTER OF DEEDS' USE ONLY
FOR NDR USE ®NL
26 Date Deed Recorded
Mo. Day Yr.
27 Value of Stamp or Exempt Number
28 Deed Book 29 Deed Page
30
Nebraska Department of Property Assessment & Taxation Authorized by Sections 76 -214, 77 -1327, R.R.S. 1943
Form No. 2- 146 -67 Rev. 12 -00 Supersedes 2- 146 -67 Rev. 9 -94
0�& NEBRASKA DEPART MENT OF REVENUE — White Copy COUNTY ASSESSOR — Canary and Pink Copies GRANTEE — Goldenrod Copy
U0 d prwted :with sey rak en recycled paper
Is
rte .__...
IN THE DISTRICT COURT OF WASHINGTON COUNTY, NEBRASKA
KEITH KLINGER AND JULIE MILLER )
KLINGER, ) Case No. CI 04 129
Plaintiffs,
vs.
SATISFACTION
UNION PACIFIC RAILROAD COMPANY,
JOHN DOE AND JANE DOE, ET AL.,
Defendants
COMES NOW the Plaintiff in the above entitled matter and hereby shows
to the Court that the obligation of the City of Blair, Nebraska, to pay the sum of
$2,084.96 has been paid and fully satisfied.
KEITH KLING
KLINGER, Pl4i
Ni� K. Jol �son;'# 12075
Attorney fir Plaintiffs
JOHNSON`,& MOCK
1904 South Street, P.O..Box 532
Blair, Nebraska 68008
(402) 426 -9626