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0� 8— COmomminimmmi rn T1 m D 77/ N 2 (.01 `) - cn 7J C-)-4 r-, 1 i r -.. rn *r N C....) U> —irn —i '— ;� W rn _t= r— :J C) r— :1- c:> r' , LI::::, co i.l co cJ fJ , Return to: Shane & Kristen Burr, 12662 S. Nebraska Hwy. 11, Wood River, NE 68883 TRANSFER ON DEATH DEED ,0 In accordance with the provisions of the NEBRASKA UNIFORM REAL PROPERTY TRANSFER ON DEATH ACT, NEB. REV. STAT. §§ 76-3401 TO 76-3423 (the "Act") Shane J. Burr and Kristen N. Burr, husband and wife, (the "Transferor"), hereby states that upon the death of the Transferor, the following described real estate (as defined in NEB. REV. STAT. 76-201): See Attached Exhibit "A" shall be transferred to Peyton M. Burr, a single person, Addison R. Burr, a single person, and Jadyn L. Burr, a single person (collectively the "Beneficiary") all in accordance with the terms and provisions of the Act. This Deed is revocable even if the Deed or another instrument contains a contrary provision. In the event any Beneficiary named above predeceases Transferor, his or her share shall be transferred to his or her issue. Such issue shall take, by right of representation, the share such deceased Beneficiary would have taken had such Beneficiary survived Transferor. Transferor states that the real estate described above is agricultural land. Therefore, my growing crops shall pass to my Beneficiary. WARNING The real estate described above 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 Beneficiary designated above is personally liable, to the extent of the value of the real estate described above that is actually transferred to the Beneficiary pursuant to this Deed, 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 Beneficiary designated above may also be personally liable, to the extent of the value of the real estate described above that is actually transferred to the Beneficiary pursuant to this Deed, for claims against the Transferor's estate, statutory allowances to the Transferor's surviving spouse and children, if any, and the expenses of administration of the Transferor's estate to the extent needed to pay such amounts by the Personal Representative of the Transferor's estate. Page 1 of 2 ON 1N3Wtlb1SNI SY 03U31N3