The undersigned closing agent with a designation of authority recorded in Book ____, Page(s) _____, or as Instrument No. _____________ of the records relating to real estate of ____________ County, Nebraska, from a title insurer authorized to transact the business of insuring titles to interests in real property in the State of Nebraska, or a member in good standing of the Nebraska State Bar Association, hereby represents: (a) The indebtedness secured by that certain security instrument, identified as a mortgage, trust deed, or deed of trust, executed by _______________as mortgagor/trustor, to _______________, as trustee, and ______________, as beneficiary or _________________, as mortgagee, recorded on _______________in book ______, page(s) _____, or as Inst No. ____________, of the mortgage records of ________________ County, Nebraska and creating a security interest in the following described real estate: _________________________________ has received full payment or performance pursuant to a payoff statement provided to the undersigned on _______________________ by __________________, the holder of the underlying indebtedness, and being the secured creditor; (b) The undersigned has satisfactory evidence that the secured creditor has received full payment or performance of the sums identified in such payoff statement; (c) The undersigned has reasonable grounds to believe that the real property described in the security instrument is residential real property; (d) The undersigned has not received notification that the secured obligation remains unsatisfied; and (e) To the best knowledge of the undersigned, the secured creditor has not recorded any instrument satisfying or releasing the security interest within sixty days following (i) the secured creditor’s receipt of full payment or performance and (ii) notification as required by law.
DATED: ____________________
________________________________
Closing agent
BY: ___________________________
STATE OF NEBRASKA
) SS.COUNTY OF )
The foregoing Certificate of Satisfaction was acknowledged before me this ____ day of ________________, 20___, by __________________, known to me to be the ________________ of _______________________, Closing Agent.
________________________________
NOTARY PUBLIC
No guidelines are available for this form at this time.