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0 <br />w <br />w <br />Return to / <br />Mary J. Livingston /to <br />P 0 Box 1563 <br />Grand Island NE 68802 <br />CASH <br />CHECK I (0.0o <br />REFUNDS: <br />CASH <br />CHECK <br />RECORDED <br />HALL COUNTY NE <br />INST Z013 0 5 12 5 2023 OCT 31 A IO" 51 <br />KRISTI WOLD <br />REGISTER OF DEEDS <br />1600 <br />TRANSFER ON DEATH <br />PURSUANT TO NEBRASKA UNIFORM REAL PROPERTY TRANSFER ON <br />DEATH ACT <br />I, Diane J. Rangel, a single person, Grantor/Transferor, transfer all of my <br />interest in the following described property to the named beneficiaries, Rhonda <br />Rangel Tallon and Richard Christopher Rangel, as joint tenants. Said transfer to <br />be effective at my death. The real estate (as defined in Neb. Rev. Stat. 76-201) in <br />Hall County, Nebraska is described as follows: <br />Lot Twenty Seven (27), Country Meadows Subdivision, in the City of Grand <br />Island, Hall County, Nebraska. <br />Also known as 4122 Prairie Ridge Lane, Grand Island, Nebraska. <br />I may revoke this deed. When recorded, this deed revokes any Transfer on <br />Death deed that I made before signing this deed. <br />WARNING: The property transferred remains subject to inheritance taxation in Nebraska to the <br />same extent as if owned by the transferor at death. Failure to timely pay inheritance taxes is <br />subject to interest and penalties as provided by law. <br />WARNING: The designated beneficiary is personally liable, to the extent of the value of the <br />property transferred, to account for medicaid reimbursement to the extent necessary to discharge <br />any such claim remaining after application of the assets of the transferor's estate. The designated <br />beneficiary may also be personally liable, to the extent of the value of the property transferred, <br />for claims against the estate, statutory allowances to the transferor's surviving spouse and <br />children, and the expenses of administration to the extent needed to pay such amounts by the <br />personal representative. <br />WARNING: The Department of Health and Human Services may require revocation of this deed <br />by a transferor, a transferor's spouse, or both a transferor and the transferor's spouse in order to <br />qualify or remain qualified for medicaid assistance. <br />Executed: October 27, 2023. <br />I, Diane J. Rangel the transferor, sign my name to this instrument this 27th day of <br />October, 2023, and being first duly sworn, do hereby declare to the undersigned authority that I <br />sign and execute this transfer on death deed to transfer my interest in the described real property <br />and that I sign it willingly or willingly direct another to sign for me, that I execute it as my free <br />and voluntary act for the purposes therein expressed, that I am eighteen years of age or older or <br />am not at this time a minor and that I am of sound mind and under no constraint or under <br />influence. <br />A\ <br />Diane J. Rangel, Tnsferor <br />