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Return to: Denise Myers, Attorney <br />611 N. Diers Ave., Ste 1 <br />Grand Island, NE 68803 <br />Notice to Owner: <br />Transfer on Death: <br />m <br />G <br />z <br />n„I <br />n <br />REVOCABLE TRANSFER ON DEATH DEED <br />Brian E. Hallner 3304 S. 105 Ave. <br />Omaha, NE 68124 <br />Scott A. Hallner 21263 E. Stacey Road <br />Queen Creek, AZ 85142 <br />�:. c ; <br />i <br />N) ..T� <br />T. f <br />r <br />r- : <br />I . <br />CD <br />x (n <br />You should carefully read all information on this form. You may want to consult a Lawyer before using this Form. If <br />you 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. Mailing Address of Owner: <br />Nelda M. Hallner 4255 Pennsylvania Ave. <br />(a single person) Grand island, NE 68803 <br />Notice to Register of Deeds: <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 Nineteen (19), Block One (1), Capital Heights Subdivision, City of Grand Island, 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 />At my death I transfer my interest in the described property to the beneficiaries as designated above. The transfer <br />occurs 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 alternate beneficiary <br />My estate <br />