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60Li0660Z OD Lri Return to: Notice to Owner: Denise Myers, Attorney P.O. Box 505 Cairo, NE 68824 REVOCABLE TRANSFER ON DEATH DEED 0 J;) You should carefully read all information on this form. You may want to consult a Lawyer before using this Form. If you are married and both spouses do not sign this deed, the deed may be void. This form must be recorded with the Register of Deeds of the County in which the property is located before your death and it also must be recorded with the Register of Deeds of the County in which the property is located within 30 days after it was signed. If either of these requirements is not met, this form will not be effective. Identifying Information about Owner: Names of Owner: Mailing Address of Owner: Wayne M. Anson 642 N Broadwell Patricia A. Anson Grand Island, NE 68803 Notice to Register of Deeds: This is a transfer on death deed and Form 521 is not required with the filing of this Transfer on Death deed under Neb. Rev. Stat. §76-214(2)(b). Legal Description: The following real estate is transferred by this document, effective at the death of the Owner to the Primary Beneficiary or to the appropriate Alternate Beneficiary as provided below. Lots One (1), and the Northerly One Foot (N1.0') of Lot Two (2), in Block Four (4), Lambert's Second Addition to the City of Grand Island, Hall County, Nebraska Primary Beneficiary: We designate the following beneficiaries of this revocable transfer on death deed if the beneficiaries survive the survivor of us. Name of Primary Beneficiary: Mailing Address of Primary Beneficiary: Kristi Dawn Young 408 North Elm St., McPherson, KS 67470 Kristin Dale Anson 717 West Edgewater St., Portage, WI 53901 Kory Drew Anson 1600 Deer Trail, Kerrville, TX 78028 Kari Danielle Ballard 607 Mill St., Alton, KS 67623 Transfer on Death: At the death of the survivor of us, we transfer our interest in the described property to the beneficiaries as designated above. The transfer occurs at the death of the survivor of the Transferors. The beneficiaries shall own the property as tenants in common. Survivorship Required: Under Nebraska Law, the interest of a designated beneficiary is contingent on the designated beneficiary surviving the transferor by one hundred twenty (120) hours. This TOD Deed is Revocable: Before my death, I have the right to revoke this deed.