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Identifying Information about Owners <br />Name of Owner <br />Eldred E. Folkers <br />REVOCABLE TRANSFER ON DEATH DEED <br />W <br />0 <br />Retum to: Jerom E. Janulewicz, 308 North Locust Street, Suite 306, Grand Island, NE 68801 <br />eg <br />Notice to Owners <br />You should each carefully read all information on this form. You may want to <br />consult a Lawyer before using this form. <br />This form must be recorded with the Register of Deeds of the County in which <br />the property is located before your death and it also must be recorded with the <br />Register of Deed 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 <br />effective. <br />Mailing Address of Owner <br />2316 North Sheridan Street <br />Grand Island, NE 68803 <br />Amy E. Folkers 2316 North Sheridan Street <br />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 <br />this Transfer on Death deed under Neb.Rev.Stat. § 76- 214(2)(b). <br />Legal Description <br />The following real estate is transferred by this document, effective at the death of <br />the survivor of the Owners to the Primary Beneficiaries. <br />