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CASH CHECK /i ) REFUNDS: CASH CHECK I t.! - NST flfl 0a 8 2 14 1013 2i REVOCATION OF TRANSFER ON DEATH DEED 1 Notice to Owner This revocation must be recorded with the Register of Deeds of the County in which the property is located and it also must be recorded with the Register of Deeds of the County in which the property is located before the death of the signer(s) and also within 30 days after it was signed or it will not be effective. This revocation is effective only as to the interests in the property of owners who sign this revocation. Identifying Information Name of Owner Dolores J. Allan Mailing Address of Owner 17596 W. Wood River Road Wood River, NE 68883 Notice to Register of Deeds This is a revocation of transfer on death deed and Form 521 is not required under Neb. Rev. Stat. 76-214(2). Legal Description West Seventy -Two Feet (W72') of Lot Ten (10Y,Wade's Subdivision,Grand Island, Hall County, Nebraska. Revocation I revoke all my previous transfers of these properties by transfer on death deed. Signature of Owner Making this Revocation GZ-2l� Dolores J. We, , Cape and �,1lU((1 I TU.-S-Ii►� , the witnesses, sign our names to this instrument, b g first duly sworn, and do Herby declare to the undersigned authority that the transferor signs and executes this revocation of transfer on death deed to revoke her interest in the 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 revocation of transfer om death deed as witness to the transferor's signing, and that to the best of his or her knowledge the transferor is eighteen years of age or older or is not a this time a minor and the transferor is of sound mind and under no constraint or undue influence.