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• <br />202003279 <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 the administration to the extent <br />needed to 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 <br />to qualify or remain qualified for Medicaid assistance. <br />Signature of Owner Making This Transfer on Death Deed <br />We, THOMAS E. MORONEY, a married person, the Transferor, and BETH E. MONEY, <br />a married person, Spouse of Transferor, sign our names to this instrument on April 3d , 2020, <br />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 <br />we sign willingly or willingly direct another to sign for us, that we execute it as our free and <br />voluntary act for the purposes therein expressed, that we are eighteen years of age or older or are <br />not at this time minors, and that we are of sound mind and under no constraint or undue <br />influence. <br />''U/0 -?-71/210, L'M 1/3e77 -V <br />THOMAS E. MORONEY, <br />Transferor <br />z <br />BETH E. MORONEY, by Thomas E. <br />Moroney, Power of Attorney for Beth E. <br />Moroney, Spouse of Transferor <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 that this deed is or would be entitled to receive <br />any interest in the land if the Transferor died under the circumstances existing at the date of <br />the signing of this deed. <br />We, W ►O iSri A and Mai►'t } [ - , the witnesses, sign our names <br />to this instrument, being first duly sworn, and do hereby declare to the undersigned authority that <br />