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Warning: The two witnesses must be disinterested for this Deed to be valid. An interested <br />witness means any individual who in the date that this Deed is or would be entitled to <br />receive any interest in the land if the Transferor died under the circumstances existing at <br />the date of the signing of this Deed. <br />We; Jessica Tavis and Ellen Province, the witnesses, sign our names to this instrument, <br />being first duly sworn, and do hereby declare to the undersigned authority that the <br />Transferor signs and executes this Transfer on Death Deed to transfer his or her interest in <br />the described real property and that he or she execute it as his or her free and voluntary <br />act for the purposes therein expressed, and that each of us, in the presence and hearing <br />of the Transferor, hereby signs this Deed as witness to the Transferor's signing, and that <br />to the best of his or her knowledge the Transferor is eighteen years of age or older and is <br />not at this time a minor and the Transferor is of sound mind and under no constraint or <br />undue influence. <br />J a Tavis <br />1 Central Avenue <br />Kearney, NE 68847 <br />Acknowledgment: <br />STATE OF NEBRASKA ) <br />) SS <br />COUNTY OF BUFFALO ) <br />Subscribed, sworn to, and acknowledged before me by Dorothy M. Meyer, the <br />Transferor, and subscribed and sworn to before me by Jessica Tavis and Ellen Province, <br />witnesses, this 28 day of July, 2015. <br />Page 3 of 3 <br />G itti/ut5r*GPLe <br />Ellen Province <br />1419 Central Avenue <br />Kearney, NE 68847 <br />20150515€ <br />