1991-08-27 HuntTO BE FILED R ea l E s t a t e rans St a t eme nt FORM
WITH REGISTER This Statement is Confidential — for Tax Officials Only
OF DEEDS a Read instructions on reverse side
e THE DEED WILL NOT BE RECORDED UNLESS THIS STATEMENT IS SIGNED AND LINES 1 THROUGH 19 ARE PROPERLY COMPLETED
COUNTY ASSESSOR'S USE ONLY
County Name County No. Sales No. Location I.D.
Property Type
(1) ❑ Single Family (4) ❑ Commercial (7) ❑ Agricultural (Total
No. of Acres )
(2) ❑ Multi Family (5) ❑ Industrial (8) ❑ Mineral Interests 1 Date of Sale 2 Date of Deed
(3) E] Home Sites (6) [] Recreational (9) ❑ Other Month Da 2 Year Month Da 2, 7 Year �
Cabins etc. Y Y
3 Grantor's Name, Address, and Telephone 4 Grantee's Name, Address, and Telephone
Grantor's Name (Seller) +.' a a: TI _r ce 13 Tri Grantee's Name (Buyer)
Rug'a W. Hunt and Jane A. Hunt he C t. of Blair, Nebraska
Street '33 O ther Mailing Address Street o Other Mailing A
City State Zip Code City State Zip Code
— B lair NE 68008 Blair N 68008
Telephone Number Telephone Number
(402) 426 -621 (4 02) 26 -4191
5 Federal Employer Identification or Social Security Number 6 Type of Deed
of Grantee(s) (if more than two, attach list) City of 'Blair Warranty er
7 Type of Transfer
Sale ❑ Gift ❑ Exchange ❑ Foreclosure ❑ Satisfaction of Contract ❑ Other (explain)
8 Ownership Transferred in Full (if no, explain) 9 Was sale between relatives? (if yes, state relationship)
YES ❑ NO ❑ YES NO
10 If the real estate was transferred for nominal 11 Was mortgage assumed? (if yes, state amount and interest rate)
consideration, what is the current market value? $ ❑ YES XU NO $
12 Does this conveyance divide a current 13 Was sale through a real estate agent? 14 Was real estate purchased for same use? (if no, explain)
parcel of land? ❑ YES NO ❑ YES IN NO Yes
15 Address of Property City State Zip Code
B lair, NE. 68008,
16 Legal Description Tax Lot 497 in Section Elev ( Town E ighteen 18 forth, Range
leve (11), E ast of the 6th ` X. , City of Blair, Washington County,
Nebraska
17 Total purchase price including any liabilities assumed......... .................. 17 $ 1 00
18 Was non real property included in purchase? ❑ Yes ❑ No (If yes, enter amount and attach itemized list) ... 18 $ 00
19 Adjusted purchase price paid for real estate line 17 minus line 18 " ' ,t 1 00
Under penalties of perjury, 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 8igg this statement.
sign 3.,.,...`
here Signature Title Date
REGISTER OF DEEDS' USE ONLY
20 Date Deed Recorded
Month Day Year
21 Value of Stamp or Exempt Number
$ ,
22 Deed Book 23
Deed Page
COUNTY ASSESSOR'S USE ONLY
24 Parcel Identification
28 Agricultural Land
Township
Section
Quar.
Subdivision
Block
Parcel Number
LVG
No. of Acres
LVG
No. of Acres
1 25 Improved Parcels
Arch Type
Occ. Code
CC
Quality
No. of Stories
Story Height
Floor Area
Basement
Finish
Garage Stall
Garage Type
Year Built
Modernization /Rehab
Miscellaneous
RCN
$ 00
Miscellaneous
Depreciation Study Reason No.
❑ YES ❑ NO
Does land adjoin current operating Irr.
unit?
❑ YES ❑ NO
Type
Total Acres /Lots
26 Platted Lots
Zoning
Irreg.
Front
Depth
29 Land Value.
29
$ 1 00
Lot Size
Street Improvement
Site Improvement
30 Improvement value
30
$ i 00
27Should this sale be used in an assessment /sales If no, give nonuseable sales code
ratio study? ❑ YES ❑ NO
31 Total value (line 29 plus
line 30 ) . . . . . . . . . . . . . .
31
$ 00
Nebraska Department of Revenue Form No. 2- 146 -67- Rev. 10 -65 AUtnonzea oy 5ectlon lb- 214, rr - tszr, it - 13Zd H.rt.Z>. 1y4J
Supersedes 2- 146 -67 Rev. 11 -79
COUNTY ASSESSOR — White and Canary Copies NEBRASKA DEPARTMENT OF REVENUE — Pink Copy GRANTEE — Goldenrod Copy
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KEEP ME
This is your legal description for your Real Estate, and ,
you will `always have it for future use.
t
City of Blair
s t
3
Tax Lot 497 in Sec 11 -18 -11
CHARLOTTE L. PETERSEN
County Clerk & Register of Deeds
Blair, Nebraska 68008'
11