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This TOD Deed is Revocable: <br />Before my death, I have the right to revoke this deed. <br />Growing Crops: <br />If this land is agricultural land the growing crops shall pass to: <br />X My primary or alternate beneficiary <br />My estate <br />I understand that if I make no choice growing crops pass to my estate. <br />Legally Required Warning in the TOD Deed: <br />Please pay close attention to the following warnings: <br />Warning: <br />Warning: <br />The property transferred remains subject to inheritance taxation in Nebraska to the same extent as <br />if owned by the transferor at death. Failure to timely pay inheritance taxes is subject to interest and <br />penalties as provided by law. <br />Warning: <br />The designated beneficiary is personally liable, to the extent of the value of the property transferred, <br />to account for Medicaid reimbursement to the extent necessary to discharge any such claim <br />remaining after application of the assets of the last surviving transferor's estate. The designated <br />beneficiary may also be personally liable, to the extent of the value of the property transferred, for <br />claims against the estate statutory allowances to the last surviving transferor's surviving spouse and <br />children, and the expenses of administration to the extent needed to pay such amounts by the <br />personal representative. <br />Warning: <br />The Department of Health and Human Services may require revocation of this deed by a transferor, <br />a transferor's spouse, or both a transferor and the transferor's spouse in order to qualify or remain <br />qualified for Medicaid assistance. <br />Signature of Owner Making This Transfer on Death Deed: <br />, rry D._McAhren and Vicki McAhren, husband and wife, the transferors, sign our names to this instrument on <br />ZG� , 2018, and being first duly sworn, do hereby declare to the undersigned authority that we sign and <br />execute this transfer on death deed to transfer our interest in the described real property and that we sign it willingly or <br />that one or both of us willingly direct another to sign for that signer or signers, that we execute it as our free and voluntary <br />act for the purposes therein expressed, that we are eighteen years of age of older or are not at this time a minor, and <br />that we are of sound mind and under no constraint or undue influence. <br />9 <br />Larry cAhren, Transferor <br />The two witnesses must be disinterested for this Deed to be valid. Interested witness means any individual who on the <br />date that this deed is executed is or would be entitled to receive any interest in the land if the transferor died under the <br />circumstances existing at the date of the signing of this deed. <br />We, 1"1 sc r-494 and j 6ri I,. / r , the witnesses, sign our names <br />to this instrument, being first duly sworn, and do hereby declare to the undersigned authority that the transferor signs <br />and executes this transfer on death deed to transfer his or her interest in the described real property and he or she signs <br />it willingly or willingly directs another to sign for him or her, and that he or she executes it as their free and voluntary act <br />for the purposes therein expressed, and the each of us, in the presence and hearing of the transferor, hereby signs this <br />deed as a witness to the transferor's signing , and that to the best of our knowledge the transferor is eighteen years of <br />age or older or is not at this time a minor and the transferor is of sound mind and under no constraint or undue influence. <br />Witness <br />- Witness <br />STATE OF NEBRASKA <br />COUNTY OF HALL <br />GENERAL NOTARY • State of Nebraska <br />DENISE D. MYERS <br />My Comm. Exp. Nov. 20, 2018 <br />) ss <br />Notary Public <br />Vicki McAhren, Transferor <br />9 S f/wy Z <br />.4:p kE OSFS?- <br />Address of Witness <br />Sa,c <br />Address of Witness <br />201801852 <br />Subscribed, sworn to, and acknowledged before me by D. McAhren-end Vicki McAhren, husband and wife, <br />tran9ferors, and subscribed and sworn to before me by k ichct� / % i i5 ft i - ' , and <br />t 43n / /'i Q witnesses, on n i Z2. , 2018. <br />