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vo <br />rn <br />rn <br />c <br />N n z <br />e v <br />rn rrj r V <br />vi .. <br />N <br />to <br />n to: <br />Id S. Depue <br />PO Box 460 <br />Grand Island, NE 68802 <br />Identifying Information about Owner(s) <br />Name of Owner <br />DEWAYNE G. NAASZ, <br />A SINGLE PERSON <br />333 S. OAK, GRAND ISLAND, NE. 68801 <br />Space Above Line Reserved for Recording Purposes <br />REVOCABLE TRANSFER ON DEATH DEED <br />Notice to Owner <br />You should carefully read all information on this form. You May Want to Consult a Lawyer before <br />Using This Form. <br />This form must be recorded with the Register of Deeds of the County in which the property is <br />located before your death and it also must be recorded with the Register of Deeds of the County <br />in which the property is located within 30 days after it was signed. If either of these requirements <br />is not met, this form will not be effective. <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 on <br />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 Owner to the <br />Primary Beneficiary or to the Alternate Beneficiary as provided below. <br />LOT 9, IN BLOCK 7, OF KOEHLER PLACE, IN THE CITY OF GRAND ISLAND, <br />HALL COUNTY, NEBRASKA. <br />Transfer on Death Deed - Page No. 1 <br />