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202203574 The designated beneficiary is personally liable, to the extent of the value of the property transferred, 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 designated beneficiary may also be personally liable, to the extent of the value of the property transferred, for claims against the estate, statutory allowances to the transferor's surviving spouse and children, and the expenses of administration to the extent needed to pay such amounts by the personal representative. Warning: The Department of Health and Human Services may require revocation of this Deed by a transferor, a transferor's spouse, or both a transferor and the transferor's spouse in order to qualify or remain qualified for Medicaid assistance. Signature of Owner Making This Transfer on Death Deed: I, Patrica K. Camp, the transferor, sign my name to this instrument on May 13, 2022, and being first duly sworn, do hereby declare to the undersigned authority that I sign and execute this Transfer on Death Deed to transfer my interest in the described real property and that I sign it willingly; that I execute it as my free and voluntary act for the purposes therein expressed; that I am eighteen years of age or older and that I am of sound mind and under no constraint or undue influence. PATRICA K. CAMP, Transferor I, Gary L. Camp, the transferor, sign my name to this instrument on May 13, 2022, and being first duly sworn, do hereby declare to the undersigned authority that I sign and execute this Transfer on Death Deed to transfer my interest in the described real property and that I sign it willingly; that I execute it as my free and voluntary act for the purposes therein expressed; that I am 3