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• <br />202300320 <br />EXHIBIT "A" WARNINGS ATTACHED <br />TO <br />A NEBRASKA TRANSFER ON DEATH DEED <br />1. RECORDING WARNING. TO BE EFFECTIVE, THIS DEED MUST BE <br />RECORDED in the public real estate records of the office of <br />the County Clerk/Register of Deeds of EACH COUNTY in which the <br />real estate is located: <br />a. BEFORE THE DEATH of the transferor(s); and <br />b. WITHIN 30 DAYS AFTER THE DATE OF BEING EXECUTED as <br />provided in the NEBRASKA UNIFORM REAL PROPERTY TRANSFER <br />ON DEATH ACT. <br />2. INHERITANCE TAX WARNING. The property transferred remains <br />subject to inheritance taxation in Nebraska to the same extent <br />as if owned by the transferor at death. Failure to timely pay <br />inheritance taxes is subject to interest and penalties as <br />provided by law. <br />3. MEDICAID REIMBURSEMENT LIABILITY WARNING. The designated <br />beneficiary is personally liable, to the extent of the value <br />of the property transferred, to account for medicaid <br />reimbursement to the extent necessary to discharge any such <br />claim remaining after application of the assets of the <br />transferor's estate. <br />4. ESTATE CLAIMS LIABILITY WARNING. The designated beneficiary <br />may be liable, to the extent of the value of the property <br />transferred, for claims against the estate, statutory <br />allowances to the transferor's surviving spouse and children, <br />and the expenses of administration to the extent needed to pay <br />such amounts by the personal representative. <br />5. HEALTH AND HUMAN SERVICES REVOCATION WARNING. The Department <br />of Health and Human Services may require revocation of this <br />deed by a transferor, a transferor's spouse, or both a <br />transferor and a transferor's spouse in order to qualify or <br />remain qualified for medicaid assistance. <br />EXHIBIT "A" WARNINGS ATTACHED <br />TO <br />A NEBRASKA TRANSFER ON DEATH DEED <br />