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CASH <br />CHECK 22 0° <br />REFUNDS: <br />CASH <br />CHECK <br />RECORDED <br />HALL CO! !'TY NE <br />(71� <br />INST 1013 0 5 1 5 2 2023 NOV - I A 11 4 I <br />KRISTI WOLD <br />REGISTER OF DEEDS <br />Return to: <br />Ronald S. Depue <br />308 N. Locust, Ste. 501 <br />Grand Island, NE 68801 <br />22 00 <br />Space Above Line Reserved for Recording Purposes <br />REVOCABLE TRANSFER ON DEATH DEED <br />Notice to Owner <br />You should carefully read all information on this form. You May Want to Consult a Lawyer before <br />Using This Form. <br />This form must be recorded with the Register of Deeds of the County in which the property is <br />located before your death and it also must be recorded with the Register of Deeds of the County <br />in which the property is located within 30 days after it was signed. If either of these requirements <br />is not met, this form will not be effective. <br />Identifying Information about Owner(s) <br />Name of Owner <br />KATHY E. EVANS <br />818 W. LOUISE ST. <br />GRAND ISLAND, NE 68801 <br />Notice to Register of Deeds <br />This is a transfer on death deed and Form 521 is not required with the filing of this Transfer on <br />Death deed under Neb. Rev. Stat. §76-214(2)(b). <br />Legal Description <br />The following real estate is transferred by this document, effective at the death of the Owner to the <br />Primary Beneficiary or to the Alternate Beneficiary as provided below. <br />The Easterly Twenty-two (E 22') Feet of Lot Five (5) and the Westerly Twenty- <br />two (W 22') Feet of Lot Six (6), all in Block Two (2), in Wiebe's Addition to the <br />City of Grand Island, Hall County, Nebraska <br />Transfer on Death Deed - Page No. 1 <br />