Form DC6:4(7) "Affidavit and Application for Preparation of Real Estate Assignment Certificate" - Nebraska

What Is Form DC6:4(7)?

This is a legal form that was released by the United States District Court for the District of Nebraska - a government authority operating within Nebraska. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2018;
  • The latest edition provided by the United States District Court for the District of Nebraska;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DC6:4(7) by clicking the link below or browse more documents and templates provided by the United States District Court for the District of Nebraska.

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Download Form DC6:4(7) "Affidavit and Application for Preparation of Real Estate Assignment Certificate" - Nebraska

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Nebraska State Court Form
AFFIDAVIT AND APPLICATION
FOR PREPARATION OF REAL
ESTATE ASSIGNMENT
DC 6:4(7) NEW 01/18
CERTIFICATE
Neb. Rev. Stat. § 42-372.02
IN THE DISTRICT COURT OF __________________ COUNTY, NEBRASKA
(county where filed)
______________________________________,
Case No. ____________________
(your full name or the name of the plaintiff in the original action)
Plaintiff,
AFFIDAVIT AND APPLICATION FOR
vs.
PREPARATION OF REAL ESTATE
__________________________________,
ASSIGNMENT CERTIFICATE
(other party's full name or the name of the defendant in the original action)
Defendant,
STATE OF NEBRASKA
)
) ss:
COUNTY OF_____________________ )
(county where signed)
The undersigned, being first duly sworn on oath, deposes and says that:
1. I am the
plaintiff/
defendant in the above entitled action and that I am of lawful age.
2. That this court entered a Decree of Dissolution of Marriage on _____________________,
in which the interest of
plaintiff/
defendant in the following described real estate in
____________________________ County, Nebraska, was assigned to
__________________________________,
plaintiff/
defendant,
Real Estate Description(s):
3. I request the clerk of the district court of ______________________ County, Nebraska,
pursuant to Neb. Rev. Stat. § 42-372.02 to prepare a Real Estate Assignment Certificate for
the above named real estate description(s). The certificate may include more than one
parcel of real estate, but a separate certificate for each party to whom real estate is assigned
and a separate certificate for each county in which real estate is located is required and
hereby requested.
Page 1 of 2
Affidavit and Application for Preparation
of Real Estate Assignment Certificate
DC 6:4(7) NEW 01/18
Nebraska State Court Form
AFFIDAVIT AND APPLICATION
FOR PREPARATION OF REAL
ESTATE ASSIGNMENT
DC 6:4(7) NEW 01/18
CERTIFICATE
Neb. Rev. Stat. § 42-372.02
IN THE DISTRICT COURT OF __________________ COUNTY, NEBRASKA
(county where filed)
______________________________________,
Case No. ____________________
(your full name or the name of the plaintiff in the original action)
Plaintiff,
AFFIDAVIT AND APPLICATION FOR
vs.
PREPARATION OF REAL ESTATE
__________________________________,
ASSIGNMENT CERTIFICATE
(other party's full name or the name of the defendant in the original action)
Defendant,
STATE OF NEBRASKA
)
) ss:
COUNTY OF_____________________ )
(county where signed)
The undersigned, being first duly sworn on oath, deposes and says that:
1. I am the
plaintiff/
defendant in the above entitled action and that I am of lawful age.
2. That this court entered a Decree of Dissolution of Marriage on _____________________,
in which the interest of
plaintiff/
defendant in the following described real estate in
____________________________ County, Nebraska, was assigned to
__________________________________,
plaintiff/
defendant,
Real Estate Description(s):
3. I request the clerk of the district court of ______________________ County, Nebraska,
pursuant to Neb. Rev. Stat. § 42-372.02 to prepare a Real Estate Assignment Certificate for
the above named real estate description(s). The certificate may include more than one
parcel of real estate, but a separate certificate for each party to whom real estate is assigned
and a separate certificate for each county in which real estate is located is required and
hereby requested.
Page 1 of 2
Affidavit and Application for Preparation
of Real Estate Assignment Certificate
DC 6:4(7) NEW 01/18
4. I understand that I, the
plaintiff/
defendant, am responsible for recording the certificate
or certificates with the register of deeds in the appropriate county or counties; and further
that this certificate shall not be used in lieu of a deed or other conveyance of real estate to
carry out the terms of the dissolution decree or as evidence of title. (Neb. Rev. Stat. § 76-
248.01)
NOTICE: DO NOT SIGN UNTIL YOU ARE IN THE PRESENCE OF A NOTARY
Date
Signature
Name
Street Address/P.O. Box
Bar Number and Firm Name (attorneys only)
City/State/ZIP Code
Phone
E-mail Address
SUBSCRIBED AND SWORN to before me this _______ day of _______________, 20_____.
__________________________
Notary Public
Page 2 of 2
Affidavit and Application for Preparation
of Real Estate Assignment Certificate
DC 6:4(7) NEW 01/18
Page of 2