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202305318 Alternate Beneficiary If my Primary Beneficiary, Tracy Hanger, does not survive me, I designate the following Alternate Beneficiary if that Alternate Beneficiary survives me: Kire Hanger, 2325 NW 43rd Street, Lincoln, NE 68528 and Ava Hanger, 2325 NW 43rd Street, Lincoln, NE 68528 Alternate Beneficiary If my Primary Beneficiary, Mindy Davison, does not survive me, I designate the following Alternate Beneficiary if that Alternate Beneficiary survives me: Tracy Hanger, 2325 NW 43rd Street, Lincoln, NE 68528 and Jessica Davison -Moan, 1925 Chemeketa St. NE, Salem, OR 97301 Alternate Beneficiary If my Primary Beneficiary, Jessica Davison -Moan, does not survive me, I designate the following Alternate Beneficiary if that Alternate Beneficiary survives me: Tracy Hanger, 2325 NW 43rd Street, Lincoln, NE 68528 and Mindy Davison, 3170 Casa de Campo, Apt 4, San Mateo, CA 94403-2181 Transfer on Death At my death, I transfer my interest in the described property to the beneficiaries as designated above. The transfer occurs at the death of the Transferor. Survivorship Required Under Nebraska law, the interest of a designated beneficiary is contingent on the designated beneficiary surviving the survivor of the Transferor by one hundred twenty (120) hours. This Transfer on Death Deed is Revocable Before my death, I have the right to revoke this Deed. Legally Required Warnings in the Transfer on Death Deed: Please pay close attention to the following warnings: 1) 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. 2) The designated beneficiary is 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 beneficiary 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. 3) 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 by Medicaid assistance.