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201'607632 <br /> EXHIBIT "A" WARNINGS ATTACHED <br /> TO <br /> A NEBRASKA TRANSFER ON DEATH DEED <br /> 1. RECORDING WARNING. TO BE EFFECTIVE, THIS DEED MUST BE <br /> RECORDED in the public real estate records of the office of <br /> the County Clerk/Register of Deeds of EACH COUNTY in which the <br /> real estate is located: <br /> a. BEFORE THE DEATH of the transferor (s) ; and <br /> b. WITHIN 30 DAYS AFTER THE DATE OF BEING EXECUTED as <br /> provided in the NEBRASKA UNIFORM REAL PROPERTY TRANSFER <br /> ON DEATH ACT. <br /> 2 . INHERITANCE TAX WARNING. The property transferred remains <br /> subject to inheritance taxation in Nebraska to the same extent <br /> as if owned by the transferor at death. Failure to timely pay <br /> inheritance taxes is subject to interest and penalties as <br /> provided by law. <br /> 3. MEDICAID REIMBURSEMENT LIABILITY WARNING. The designated <br /> beneficiary is personally liable, to the extent of the value <br /> of the property transferred, to account for medicaid <br /> reimbursement to the extent necessary to discharge any such <br /> claim remaining after application of the assets of the <br /> transferor' s estate. <br /> 4 . ESTATE CLAIMS LIABILITY WARNING. The designated beneficiary <br /> may be liable, to the extent of the value of the property <br /> transferred, for claims against the estate, statutory <br /> allowances to the transferor' s surviving spouse and children, <br /> and the expenses of administration to the extent needed to pay <br /> such amounts by the personal representative. <br /> 5 . HEALTH AND HUMAN SERVICES REVOCATION WARNING. The Department <br /> of Health and Human Services may require revocation of this <br /> deed by a transferor, a transferor' s spouse, or both a <br /> transferor and a transferor' s spouse in order to qualify or <br /> remain qualified for medicaid assistance. <br /> EXHIBIT "A" WARNINGS ATTACHED <br /> TO <br /> A NEBRASKA TRANSFER ON DEATH DEED <br />