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20180592.0 <br /> Transfer on Death <br /> At the death of the last of us to die, we transfer our interest in the described property to the <br /> beneficiary as designated above. The transfer occurs at the death of the last of the Transferors to <br /> die. <br /> Survivorship Required <br /> Under Nebraska law, the interest of a designated beneficiary is contingent on the designated <br /> beneficiary surviving the Transferors by one hundred twenty hours. <br /> This TOD Deed is Revocable <br /> Before our deaths, we have the right to revoke this deed. <br /> Legally Required Warnings in the TOD Deed: <br /> Please pay close attention to the following warnings. <br /> Warning: <br /> The property transferred remains subject to inheritance taxation in Nebraska to the same <br /> extent as if owned by the transferor at death. Failure to timely pay inheritance taxes is <br /> subject to interest and penalties as provided by law. <br /> Warning: <br /> The designated beneficiary is personally liable, to the extent of the value of the property <br /> transferred, to account for Medicaid reimbursement to the extent necessary to discharge <br /> 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 <br /> property transferred, for claims against the estate, statutory allowances to the transferor's <br /> surviving spouse and children, and the expenses of administration to the extent needed to <br /> pay such amounts by the personal representative. <br /> Warning: <br /> The Department of Health and Human Services may require revocation of this deed by a <br /> transferor, a transferor's spouse,or both a transferor and the transferor's spouse in order to <br /> qualify or remain qualified for Medicaid assistance. <br /> Signature of Owners Making This Transfer on Death Deed <br /> We, Richard J. Merrick and Linda J. Merrick,the transferors, sign our names to this instrument <br /> on September to -' , 2018 , and being first duly sworn, do hereby declare to the undersigned <br /> authority that we sign and execute this transfer on death deed to transfer our interest in the <br /> described real property and that we sign it willingly or willingly direct another to sign for us,that <br /> we execute it as our free and voluntary act for the purposes therein expressed,that we are <br /> eighteen years of age or older or are not at this time minors, and that we are of sound mind and <br /> under no constraint or undue influence. <br /> Ric and J. Merrick, Trans eror in• . J. Me ' r, Tran eror <br /> Warning: The two witnesses must be disinterested for this Deed to be valid. An interested <br /> witness means any individual who, on the date of this deed, is or would be entitled to receive <br /> any interest in the land under this transfer on death deed if the transferors died under the <br /> circumstances existing at the date of the signing of this deed, or any child, spouse, or heir of <br /> that person. <br /> We, [\ e�+a \4. 1�C1.c rN� and Edo / /2. X,Cflt6# ,the <br /> witnesses, s-' n our names to thnstrument, being first duly sworn, and do hereby declare to the <br /> undersigned authority that the transferors sign and execute this transfer on death deed to transfer <br /> their interest in the described real property and that they sign it willingly or willingly direct <br /> another to sign for them, and that they execute it as their free and voluntary act for the purposes <br /> therein expressed, and that each of us, in the presence and hearing of the transferors, hereby <br /> Page2of3 <br />