Laserfiche WebLink
expenses of administration to the extent needed to pay such amounts by <br />the personal representative. <br />Warning: <br />The Department of Health and Human Services may require revocation of <br />this deed by a transferor, a transferor's spouse, or both a transferor and <br />the transferor's spouse in order to qualify or remain qualified for Medicaid <br />assistance. <br />Signature of owners Making This Transfer on Death Deed <br />We, Eldred E. Folkers, and Amy E. Folkers the transferors, sign our names to <br />this instrument on /? , 2015, and being first duly <br />sworn, do hereby declare to the undersigned authority that we sign and execute <br />this transfer on death deed to transfer our interest in the described real property <br />and that we sign it willingly or that one or both of us willingly direct another to <br />sign for that signer or signers, that we execute it as our free and voluntary act for <br />the purposes therein expressed, that we are eighteen years of age or older or are <br />not at this time a minor, and that We are of sound mind and under no constraint <br />or undue influence. <br />Eldred E. Folke s, Transferor A m y , <br />We, SI�f2i �0. /0 CS � v-\ and er; �• P , the witnesses, sign <br />our names to this instrument, being first duly sworn, and do hereby declare to the <br />undersigned authority that the transferors sign and execute this transfer on death <br />deed to transfer their interest in the described real property and they sign it <br />willingly or either or both of them willingly directs another to sign for either or both <br />of them, and that they execute it as their free and voluntary act for the purposes <br />therein expressed, and that each of us, in the presence and hearing of the <br />transferors, hereby signs this deed as witness to the transferors' signing, and that <br />to the best of his or her knowledge the transferors are eighteen years of age or <br />older or are not at this time minors and the transferors are of sound mind and <br />under no constraint or undue influence. <br />..A )1).9.)6, 11 �t J1 <br />Witness name <br />Witness n e <br />201501191. <br />C2/7. 60. /-672.&12 <br />. Folkers Transferor <br />t y I L A w..e S . <br />Witness address <br />I'11 C <br />Witness address <br />