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INST 2013 ObOl1 <br />Return to: <br />Ronald S. Depue <br />308 N. Locust, Ste. 501 <br />Grand Island, NE 68801 <br />CASH <br />CHECK ,2 ;0"0 <br />REFUNDS: <br />CASH <br />CHECK <br />RECORDED <br />HALL C r `_'NT\i NE <br />2023 NOV 11 A 11: 12 <br />i^;i�ISI WOLO <br />REGISTER OF DEEDS <br />Space Above Line Reserved for Recording Purposes <br />REVOCABLE TRANSFER ON DEATH DEED <br />(More than One Owner) <br />Notice to Owners <br />You should each carefully read all information on this form. You May Want to Consult a Lawyer <br />before 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 />LaVERN E. SHAW <br />ROSE MARY SHAW <br />Mailing Address of Owner <br />114 E. 21ST ST. <br />GRAND ISLAND, NE 68801 <br />114 E. 21ST 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 survivor of. <br />the Owners to the Primary Beneficiary or to the Alternate Beneficiary as provided below. <br />Lot Two (2), Block Two (2), in Knickrehm Second Addition to the City of Grand Island, <br />Hall County, Nebraska <br />Primary Beneficiary <br />We designate the following beneficiary of this revocable transfer on death deed if the beneficiary <br />survives both of us. <br />Transfer on Death Deed - Page No. 1 <br />