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g <br />r z? <br />VI i <br />r <br />N N ° <br />W <br />\ <br />,N• ,,. <br />u., <br />Eli H. chroeder <br />220 Pa ue <br />Hebron, E 68370 <br />Notice to Owner: <br />m <br />-n <br />z <br />m a w <br />X_ <br />Identifying Information about Owner: <br />Name of Owner <br />Eli H. Schroeder <br />REVOCABLE TRANSFER ON DEATH DEED <br />r z <br />You should carefully read all information on this form. You May Want to Consult a <br />Lawyer before Using This Form. <br />This form must be recorded with the Register of Deeds of the County in which the property <br />is located before your death and it also must be recorded with the Register of Deeds of <br />the County in which the property is located within thirty (30) days after it was signed. If <br />either of these requirements is not met, this form will not be effective. <br />Mailing Address of Owner <br />220 Park Avenue, Hebron, NE 68370 <br />Notice to Register of Deeds: <br />This is a transfer on death deed and Form 521 is not required with the filing of this Transfer <br />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 the <br />Owner to the Primary Beneficiary or to the Alternate Beneficiary as provided below. <br />Lot 3, except the Westerly Five (5) feet thereof, in Block Nine (9), in Parkhill Third <br />Subdivision, and addition to the City of Grand Island, Hall County, Nebraska. <br />