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Return to: <br />Sonya K. Koperski <br />Koperski Law Office <br />P.O. Box 2195 <br />Grand Island, NE 68802 -2195 <br />i"1 <br />rra 7— <br />-TI Fi <br />c f'1 <br />Z <br />N <br />tit <br />REVOCABLE TRANSFER ON DEATH DEED <br />WARNING: The property transferred remains subject to inheritance taxation in <br />Nebraska to the same extent as if owned by the transferor at death. Failure to timely pay <br />inheritance taxes is subject to interest and penalties as provided by law. <br />WARNING: The designated beneficiary is personally liable, to the extent of the value of <br />the property transferred, to account for medicaid reimbursement to the extent necessary to <br />discharge any such claim remaining after application of the assets of the transferor's estate. The <br />designated beneficiary may also be personally liable, to the extent of the value of the property <br />transferred, for claims against the estate, statutory allowances to the transferor's surviving spouse <br />and children, and the expenses of administration to the extent needed to pay such amounts by the <br />personal representative. <br />WARNING: 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 the transferor's spouse in <br />order to qualify or remain qualified for medicaid assistance. <br />ROSAMAY E. WHEELER, a single person, (herein referred to as "Grantor "), does <br />hereby convey unto Grantees, REBECCA R. WHEELER, RACHAEL L. WHEELER, and <br />KATIE M. WHEELER , (herein referred to as "Grantees "), effective upon my death the <br />following described real property located in Grand Island, in the County of Hall, State of <br />Nebraska; <br />Lot Four (4), in Block One (1), in Island Acres Number Two, being a replat of <br />Lot One, Two, Three, Five, Six and Seven, in Island Acres, a subdivision in the <br />City of Grand Island, Hall County, Nebraska <br />