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�✓ After Recording, Mail To: <br />Mr. Dan L. Nissen <br />9164 W. Calavar Rd. <br />Peoria, AZ 85381 <br />REVOCABLE TRANSFER ON DEATH DEED <br />I <br />Owner Making This Deed: IDENTIFYING INFORMATION <br />DAN L. NISSEN <br />9164 W. Calavar Rd. <br />Peoria, AZ 85381 <br />20200895'7 <br />Legal description of the property located in the County of Hall, State of Nebraska: <br />Fractional Lot Seven (7) in Fractional Block Twenty (20), in Palmer's Subdivision of Lot Seven (7), <br />Of County Subdivision of the Southeast Quarter of the Southwest Quarter (SEI/4SW1/4) of Section <br />Sixteen (16), in Township Eleven (11) North, Range Nine (9) West of the 6th P.M., in Grand Island, <br />Hall County, Nebraska, and its complement Fractional Lot Seven (7), in Fractional Block Twenty <br />(20) in Kernohan and Decker's Addition to the City of Grand Island, Hall County, Nebraska. <br />Tax Parcel Number: 400072602 <br />PRIMARY BENEFICIARY <br />I designate the following beneficiary if the beneficiary survives me: Lisa J. Norton. <br />ALTERNATE BENEFICIARY <br />If my primary beneficiary does not survive me, the transfer to that beneficiary shall be <br />made to the following named successor beneficiary: Russell W. Nissen. <br />TRANSFER ON DEATH <br />At my death, I transfer my interest in the described property to the beneficiaries as <br />designated above. Before my death, I have the right to revoke this deed. <br />SIGNATURE OF OWNER MAKING THIS INSTRUMENT <br />I, the transferor, sign my name to this instrument this 22nd day of October, 2020, and being first <br />duly sworn, do hereby declare to the undersigned authority that I sign and execute this transfer <br />on death deed to transfer my interest in the described real property and that I sign it willingly or <br />willingly direct another to sign for me, that I execute it as my free and voluntary act for the <br />purposes e'tfin expressed, that I am eighteen years of age or older or am not at this time a <br />minor, a d thAt I am of sound mind and under no constraint or undue influence. <br />DAN L. <br />