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202301728 this Deed, for claims against the Transferor's estate, statutory allowances to the Transferor's surviving spouse and children, if any, and the expenses of administration of the Transferor's estate to the extent needed to pay such amounts by the Personal Representative of the Transferor's estate. WARNING The Department of Health and Human Services may require revocation of this Deed by the Transferor, or the Transferor's spouse, if any, or both the Transferor and the Transferor's spouse, if any, in order to qualify or remain qualified for Medicaid assistance. I, Barbara Jean Zapata, the Transferor, sign my name to this instrument this 7th day of April, 2023, 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 above-described real property and that I sign it willingly or willingly direct another to sign for me, that I execute it as my free and voluntary act for the purposes therein expressed, that I am eighteen years of age or older or am not at this time a minor, and that I am of sound mind and under no constraint or undue influence. arbara Jean Za ta, Trans ror a/A We, O1/4.hvk Let and A ': L..vt1- , the witnesses, sign our names to this instrument, and being first duly sworn, do hereby declare to the undersigned authority that the Transferor signs and executes this Transfer on Death Deed to transfer her interest in the above- described real property and that she signs it willingly or willingly directs another to sign for her, and that she executes it as her free and voluntary act for the purposes therein expressed, and that each of us, in the presence and hearing of the Transferor, hereby signs this Deed as witness to the Transferor's signing, and that to the best of our knowledge the Transferor is eighteen years of age or older or is not at this time a minor and the nsferor is of sound mind and under no consxraint or undue influence. STATE OF NEBRASKA ) ss. COUNTY OF ADAMS Witness Subscribed, sworn to, and acknowledged before me by Barbara Jean Zapata, the Transferor, and subscribed and sworn to before me by 4 vuv•- k.Let L. kt-rl. and .4 t 3-0 t , the witnesses, this 7th day of April,. Notary Public Barbara Jean Zapata Transfer on Death Deed Seal: 2 of 2 General Notary - State of Nebraska ANTONIO J. CARRANZA My Comm. Exp. June 16, 2026.