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Fill and Sign the Chapter 10 Real Property Nebraska Department of Revenue Form

Fill and Sign the Chapter 10 Real Property Nebraska Department of Revenue Form

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Real Estate Attachment Approved by Conference of Chief Judges: Draft General Rules Form 12 Page 1 of 1 Revised: 12/12/03 Real Estate Attachment Fill out a separate Attachment for each parcel of real estate. 1. Real Estate belongs to (list all owners): 2. Street Address of the real estate is: City: State: Zip Code: The property is in County. 3. Legal Description is: (Use the full legal description from the deed. If the legal description is long, you may use an attachment. Type or print neatly.) _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ ___________________________________________________ 4. Purchase date:___________(month, day, year) and purchase price:$ . 5. Mortgages or loans: (Write “NONE” if there is no mortgage) 1 st Mortgage: Amount currently owed: $ and name of lender: . 2 nd Mortgage: Amount currently owed: $ and name of lender: . 6. Current Market Value of this property: $ . 7. This property is the homestead: Yes No. Agreement of the Parties 1. All right, title, and interest of husband and wife in the real estate described above shall be awarded to: Husband Wife. 2. Husband and Wife also agree that: (Describe any liens in favor husband or wife, or other agreements about the use, sale of, or award of the property. Attach additional pages if needed. If there are no other agreements, write “None”.) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 3. The Mortgage(s) or Loan(s) described above shall be paid by Husband Wife starting on the following date: (write “NONE” if there is no mortgage or loan).

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