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/ . I, Ma ilyn B. Wiese, a Transferor sign my name to this instrument this ,,.?ma y of !� /altd being first duly sworn, do hereby declare to the undersigned a hority tha I sign and execute this Transfer on Death Deed to transfer my interest in the described real property and that I sign it willingly, that I execute it as my free and voluntary act for the purposes therein expressed, that I are not at this time a minor, and that I am of sound mind and under no constraint or undue influence. Executed: f , We, (ca J f /3 • / o h So riand �, CItrI € l ttg ✓'M ct \. , the witnesses, sign our names to this instrument, being first duly sworn, and do hereby declare to the undersigned authority that the Transferor signs and executes this Transfer on Death Deed to transfer her interest in the described real property and that she signs it willingly and that she executes it as her free and voluntary act for the purposes therein expressed, and that each of us, in the presence and hearing of the Transferor, hereby sign this deed as witness to the Transferor's signing, and that to the best of her knowledge the Transferor is not at this time a minor and the Transferok is of sound mind and under no constraint or undue influence. DOCS/1814264.1 State of Nebraska, County of Witness's name a addres A6, s c r. r roi P .s ./ (e t / —L 3 e c/ / Subscribed, sworn to and acknowledged before me by Marilyn B. Wiese, also known as Marilyn R. Wiese, also known as Marilyn Robb Wig e, a single person, the Transferor, and subscribed and sworn to before me by (TAi f i nip SZFJ and c S (41(4,2 rr- G witnesses, on f eb 3 . GENERAL NOTARY • State of Nebraska TERRY M. CONNICK My Comm. Exp. October 31, 2019 Marilyn B iese, Transferor Page 2 of 2 — ss. la Notary blic 201700906 .ess's, le and address de, vie S C_G► t At2." /`1 3) i AatA . r.tr-- Rue, This Transfer on Death Deed is made in accordance with the Nebraska Uniform Real Property Transfer on Death Act, Neb. Rev. Stat. § §76 -3401 to 76 -3423. This deed must be recorded with the Hall County, Nebraska, Register of Deeds (1) before the Transferor's death and it also must be recorded with the Hall County, Nebraska, Register of Deeds (2) within thirty (30) days after it was signed. If either of these requirements is not met, this deed will not be effective. A Real Estate Transfer Statement, Form 521 is not required with the filing of this deed under Neb. Rev. Stat. §76- 214(2)(b). A cover sheet and death certificate are to be recorded upon death of Transferor, Neb. Rev. Stat. §76- 2.126.