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£ 6 LZ0 20Z <br />cn <br />CO <br />Return to Wroblewski & Gawrych Law Office LLC (Space above this line for Recording Stamps) <br />Preparer: P.O. Box 23, St. Paul, NE 68873-0023 <br />REVOCABLE TRANSFER ON DEATH DEED <br />Notice to Owners <br />You should each carefully read all information on this form. You May Want to Consult a Lawyer before <br />Using This Form. <br />This form must be recorded with the Register of Deeds of the County in which the property is located before <br />your death and it also must be recorded with the Register of Deeds of the County in which the property is <br />located within 30 days after it was signed. If either of these requirements is not met, this form will not be <br />effective. <br />Identifying Information about Owners <br />Name of Owners <br />Drue R. Gellatly <br />Minnie M. Gellatly <br />Mailing Address of Owners <br />208 Sunny Drive <br />Doniphan, NE 68832 <br />Notice to Register of Deeds <br />This is a Transfer on Death Deed and Form 521 is not required with the filing of this Transfer on Death Deed <br />under Neb. Rev. Stat. 76-214(2)(b). <br />Legal Description <br />The following real estate is transferred by this document, effective at the death of the survivor of the Owners <br />to the Primary Beneficiary or to the Alternate Beneficiary as provided below. <br />Lot Fifteen (15), Whites Sunny Slopes Subdivision, Hall County, Nebraska. <br />Primary Beneficiary <br />We designate the following the Primary Beneficiaries of this Revocable Transfer on Death Deed in the event <br />that the Primary Beneficiary survives the survivor of us. <br />Drue R. Gellatly initials Minnie M. Gellatly initials <br />Page 1 of 3 <br />