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��r <br />N MINIM <br />s <br />Return to: Denise Myers, Attorney <br />611 N. Diers Ave., Ste 1 <br />Grand Island, NE 68803 <br />Notice to Owner: <br />You should carefully read all information on this form. You may want to consult a Lawyer before using this Form. If you <br />are married and both spouses do not sign this deed, the deed may be void. <br />This form must be recorded with the Register of Deeds of the County in which the property is located before your death <br />and it also must be recorded with the Register of Deeds of the County in which the property is located within 30 days <br />after it was signed. If either of these requirements is not met, this form will not be effective. <br />Identifying Information about Owner: <br />Names of Owner: <br />Diana Church <br />(a single person) <br />Notice to Register of Deeds: <br />Transfer on Death: <br />REVOCABLE TRANSFER ON DEATH DEED <br />Mailing Address of Owner: <br />P.O. Box 134 <br />Cairo, NE 68824 <br />This is a transfer on death deed and Form 521 is not required with the filing of this Transfer on Death deed under Neb. <br />Rev. Stat. §76- 214(2)(b). <br />Legal Description: <br />The following real estate is transferred by this document, effective at the death of the Owner to the Primary Beneficiary <br />or to the appropriate Alternate Beneficiary as provided below. <br />Lot Two (2), Block One (1), Seventh Addition to the Village of Cairo, Hall County, Nebraska. <br />Primary Beneficiary: <br />I designate the following beneficiaries of this revocable transfer on death deed if the beneficiaries survive me: <br />Name of Primary Beneficiaries: Mailing Address of Primary Beneficiaries: <br />Sara Church P.O. Box 134, Cairo, NE 68824 <br />At my death I transfer my interest in the described property to the beneficiaries as designated above. The transfer occurs <br />at my death. <br />Survivorship Required: <br />Under Nebraska Law, the interest of a designated beneficiary is contingent on the designated beneficiary surviving the <br />transferor by one hundred twenty (120) hours. <br />This TOD Deed is Revocable: <br />Before my death, I have the right to revoke this deed. <br />Growing Crops: <br />If this land is agricultural land the growing crops shall pass to: <br />X My primary or altemate beneficiary <br />My estate <br />I understand that if I make no choice growing crops pass to my estate. <br />r , <br />1 <br />Ga <br />i <br />