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LL960£Z0Z INST 1013 O l b l l TRANSFER ON DEATH DEED CASH CHECK &p.a.-3 REFUNDS: CASH CHECK HALL mit NE 1013 AP2 0 [ "x'55 WOLD REGISTER OF DEEDS MONICA R. DINKEL and MICHAEL P. DINKEL, wife and husband, TRANSFERORS, do hereby transfer and convey to the following Beneficiary: KENADI R. DINKEL, GRANTEE/BENEFICIARY, effective on the death of both Transferors, the following described real estate: Lot Four (4), Except the Northerly Sixty -Six (66) feet of the Westerly Three (3) feet, Block Thirty -Seven (37), Charles Wasmer's Addition to the City of Grand Island, Hall County, Nebraska. WARNING: The property transferred 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 designated beneficiaries are 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 beneficiaries 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. WARNING: Transferor's insurance coverage may terminate on their death. To avoid a gap in coverage Grantees/Beneficiaries are urged to obtain insurance coverage immediately on death of the Transferor. It is also recommended that Grantor add Grantee on their existing hazard insurance policy as an additional insured. EXECUTED this %7 �'l day of Apri/ , 2023. I, MONICA R. DINKEL and MICHAEL P. DINKEL, the transferors, sign our name to this instrument this 61-k day of Apr[ / , 2023, and being first duly sworn, do hereby declare to the undersigned authority that we sign and execute this transfer on death deed to transfer our interest in the described real property and that we sign it willingly or willingly direct another to sign for us, that we execute it as our free and voluntary act for the purposes therein expressed, that we are eighteen years of age or older or are not at this time minors, and that we are of sound mind and under no constraint or undue influence. Return to: Paul J. Blazek BLAZEK & GREGG, P.C., L.L.O. 1405 N. 205th St., Ste. 120 Elkhorn, Nebraska 68022 (402) 496-3432 MONICA ' . DINKE rant • , Transferor MICHAEL P. DINKEL, Grantor, Transferor