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c;) <br />r\) <br />=:D <br />173 <br />Return to: <br />Notice to Owner: <br />Denise Myers, Attorney <br />P.O. Box 505 <br />Cairo, NE 68824 <br />REVOCABLE TRANSFER ON DEATH DEED <br />You should carefully read all information on this form. You may want to consult a Lawyer before using this Form. If <br />you are married and both spouses do not sign this deed, the deed may be void. <br />This form must be recorded with the Register of Deeds of the County in which the property is located before your death <br />and it also must be recorded with the Register of Deeds of the County in which the property is located within 30 days <br />after it was signed. If either of these requirements is not met, this form will not be effective. <br />Identifying Information about Owner: <br />Names of Owner: Mailing Address of Owner: <br />Colleen J. Carey 3028 N Webb Road <br />(a single person) Grand Island, NE 68803 <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 under Neb. <br />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 Owner to the Primary Beneficiary <br />or to the appropriate Alternate. Beneficiary as provided below. <br />Lot One (1), Bluhm Subdivision, Hall County, Nebraska. <br />Primary Beneficiary: <br />I designate the following beneficiaries of this revocable transfer on death deed (as tenants in common) if the <br />beneficiaries survive me: <br />Name of Primary Beneficiaries: Mailing Address of Primary Beneficiaries: <br />William R. Carey 1120 E. Bismark Road <br />Grand Island, NE 68801 <br />Transfer on Death: <br />At my death I transfer my interest in the described property to the beneficiaries as designated above. The transfer <br />occurs at my death. <br />Survivorship Required: <br />Under Nebraska Law, the interest of a designated beneficiary is contingent on the designated beneficiary surviving the <br />transferor by one hundred twenty (120) hours. <br />This TOD Deed is Revocable: <br />Before my death, I have the right to revoke this deed. <br />Growing Crops: <br />If this land is agricultural land the growing crops shall pass to: <br />X My primary or alternate beneficiary <br />My estate <br />I understand that if I make no choice growing crops pass to my estate. <br />roie <br />Irn <br />rn <br />gio <br />VY <br />tan <br />7.73 <br />rn <br />/tO <br />