Nebraska State Court Form REQUIRED AFFIDAVIT OF SEX OFFENDER REGISTRY SEARCH CC 16:2.30 Rev 01/15 Page 1 of 1 Affidavit of Sex Offender Registry Search CC 16:2.30 Rev. 01/2015 IN THE COUNTY COURT OF COUNTY, NEBRASKA CASE IN THE MATTER OF AFFIDAVIT OF SEX OFFENDER REGISTRY SEARCH Ward/Protected Person/ Incapacitated Person I, , swear that I have completed the online search of the Nebraska Sex Offender Registry for the proposed guardian or conservator as shown by the attached printouts of the search page and results. Date Signature Name Bar Number and Firm Name (attorneys only) Street Address/P.O. Box City/State/ZIP Code Phone E-mail Address State of ) ) ss. County of ) The foregoing instrument was acknowledged before me by , this Name day of . Day Month Year Notary Public (Signature of Person Taking Acknowledgment) (Serial Number, if any) (Title or Rank) My commission expires: American LegalNet, Inc. www.FormsWorkFlow.com