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Name of Primary Beneficiaries <br />Amber R. Falldorf <br />Ann M. Beeken <br />Colby R. Falldorf <br />Transfer on Death: <br />2020034'7 <br />Mailing Address of Primary Beneficiaries <br />2434 Dodge Street <br />Lincoln, NE 68527 <br />801 West 3rd Street <br />Ogallala, NE 69153 <br />6451 Saline Drive <br />Lincoln, NE 68504 <br />At the death of the survivor of us, we transfer our interest in the described property to the <br />beneficiaries as designated above. The transfer occurs at the death of the survivor of the Transferors. <br />Survivorship Required: <br />Under Nebraska law, the interest of a designated beneficiary is contingent on the designated <br />beneficiary surviving the survivor of the transferors by one hundred twenty hours. <br />This TOD Deed is Revocable: <br />Before our death, we (or the survivor of us) have the right to revoke this deed. <br />Growing Crops: <br />If this land is agricultural land the growing crops shall pass to: <br />The primary or alternate beneficiary <br />The estate of the survivor of us <br />We understand that if we make no choice growing crops pass to the estate of the survivor of us. <br />Legally Required Warning 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 subject <br />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 any <br />such claim remaining after application of the assets of the last surviving transferor's estate. <br />The 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 last surviving <br />transferor's surviving spouse and children, and the expenses of administration to the extent <br />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 to <br />qualify or remain qualified for Medicaid assistance. <br />Signature of Owners Making This Transfer on Death Deed: <br />2 <br />