201905343 - Laserfiche WebLink

Browse

REVOCABLE TRANSFER ON DEATH DEED C :> Cr) _{ W l r _I) D CD r -- r- -r- r c7D NOTICE TO OWNER: You should carefully read all information on the other side of 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. rn rn N v o � H co -1 O C.J, 2, rrl ca y CD WARNING: The property transferred remains subject to inheritance taxation in Nebraska to the same extent as if owned by the transferor at death. Failure to timely pay inheritance taxes is subject to interest and penalties as provided by law. WARNING: The designated beneficiary is personally liable, to the extent of the value of the property transferred, to account for Medicaid reimbursement to the extent necessary to discharge any such claim remaining after application of the assets of the transferor's estate. The designated beneficiary may also be personally liable, to the extent of the value of the property, for claims against the estate, statutory allowances to the transferor's surviving spouse and children, and the expenses of administration to the extent needed to pay such amounts by the personal representative. WARNING: The Department of Health and Human Services may require revocation of this deed in order to qualify for Medicaid assistance. This form must be recorded before your death, or it will not be effective. IDENTIFYING INFORMATION Owner or Owners Making This Deed: Larry D. Ogden 413 N. Cherokee Grand Island, NE 68803 Legal description of the property: Lot nineteen (19), in Block One (1), in Dale Roush Second Subdivision in the E1/2SW1/4 of Section Fourteen (14), Township Eleven (11) North, Range Ten (10), West of the Sixth P.M., in Hall County, Nebraska.