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CASH <br />CHEC <br />REFUNDS: <br />..- CASH <br />N.) CHEC <br />co RECORDED <br />�_ HALL COUNTY NE <br />INST 202 00891 20211 MAR -14 A11:02 <br />KRIS TI WOLD <br />REGISTER OF DEEDS <br />Return to <br />Galen E. Stehlik <br />P 0 Box 400 <br />Grand Island NE 68802 <br />/(, <br />TRANSFER ON DEATH DEED <br />PURSUANT TO NEBRASKA UNIFORM REAL PROPERTY TRANSFER ON <br />DEATH ACT <br />I, Sue E. Rohweder a single person, Grantor/Transferor, transfer all of my interest in the <br />following described property to Blair D. Fernau. Said transfer to be effective at my death. The <br />real estate (as defined in Neb. Rev. Stat. §76-201) in Hall County, Nebraska is described as <br />follows: <br />Suite Two, Brentwood by the Lake Condominium Property Regime 1, in the City of Grand <br />Island, Hall County, Nebraska. <br />I may revoke this deed. When recorded this deed revokes any Transfer on Death deed that <br />I made before signing this deed. <br />Executed: IF , 2024. <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 subject <br />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, for <br />claims against the estate, statutory allowances to the transferor's surviving spouse and children, <br />and the expenses of administration to the extent needed to pay such amounts by the personal <br />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 />I, Sue E. R hweder, a single person, the transferor, sign my name to this instrument this <br />2(,,' day of A -t t j , 2024, and being first duly sworn, do hereby declare to the <br />undersigned authority that I sfgn and execute this transfer on death deed to transfer my interest in <br />the described real property and that I sign it willingly or willingly direct another to sign for me, <br />that I execute it as my free and voluntary act for the purposes therein expressed, that 1 am eighteen <br />years of age or older or am not at this time a minor and that I am of sound mind and under no <br />constraint or under influence. <br />Sue E. Rohweder, Transferor <br />