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tri <br />faJ 1�� <br />U1 <br />Once recorded, return to: <br />yt\'' Parker, Grossart, Bahensky, Beucke & Bowman, L.L.P. <br />P.O. Box 1600, Kearney, NE 68848 -1600 <br />Notice to Owner: <br />Mark J. Allen and <br />Jordan L. Allen <br />Notice to Register of Deeds: <br />Legal Description: <br />v <br />REVOCABLE TRANSFER ON DEATH DEED <br />You should carefully read all information on this form. You May Want To consult a Lawyer before <br />Using This Form. <br />This form must be recorded with the Register of Deeds of the County in which the property is located <br />before your death and it also must be recorded with the Register of Deeds of the County in which the <br />property is located within 30 days after it was signed. Neither of these requirements is not met, this <br />form will not be effective. <br />Identifying Information about Owner: <br />Names of Owner: Mailing Address of Owner: <br />3114 Brentwood Blvd. <br />Grand Island, NE 68801 <br />This is a transfer on death deed and Form 521 is not required with the filing of this Transfer on Death <br />deed under Neb. Rev. Stat. §76- 214(2)(b). <br />The following real estate is transferred by this document, effective at the death of the Owner to the <br />Primary Beneficiary or to the appropriate Alternate Beneficiary as provided below. <br />Lot Thirteen (13), Block One (1), Brentwood Second Subdivision in the City of <br />Grand Island, Hall County, Nebraska. <br />Primary Beneficiary: <br />We designate the following beneficiary of this revocable transfer on death deed if the beneficiary <br />survives the survivor of us. <br />Name of Primary Beneficiary: Mailing Address of Primary Beneficiary: <br />Eric J. Allen, Trustee under the Mark J. 164 Ponderosa Court <br />Allen Trust Agreement dated May 31, 2013 Grand Island, NE 68803 <br />m <br />—a <br />111 <br />rr7 <br />D <br />C <br />rn <br />