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N W Return to: INST MN 02233 Debbie S. Ewoldt 1615 W Stolley Park Road Grand Island, NE 68801 REVOCABLE TRANSFER ON DEATH DEED Notice to Owner You should carefully read all information on this form. CASH 00 CHECK REFUNDS: CASH CHECK RECORDED HALL t: ` Ny NE 2024 14i . i 2: 20 Ki% i8 REGISTER Lu r DEEDS 22.00 This transfer on death deed must be recorded with the Register of Deeds of the County in which The property is located, before your death and within 30 days after being signed. If either of these requirements is not met, the transfer on death deed will not be effective. Identifying Information about Owners Name of Owners Debbie S. Ewoldt Mailing Address of Owners 1615 W Stolley Park Road Grand Island, NE 68801 Notice to Register of Deeds This is a transfer on death deed, and form 521 is not required with the filing of this transfer on death deed under Neb. Rev. Stat. § 76-214(2)(b). Legal Description The following real estate is transferred by this document, effective at the deaths of the Owner, to the beneficiary as provided below: Lot 26, Hagges' Subdivision to the city of Grand Island, Hall County, Nebraska Subject to easements and restrictions of record Beneficiary I designate the following beneficiary of this revocable transfer on death deed if the beneficiary survives me: Name of Beneficiary Valerie McKay Fischer Mailing Address of Beneficiary 707 W John ST Grand island, NE 68801 Transfer on Death At my death, I transfer my interest in the described property to the beneficiary 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 Transferor by one hundred twenty hours. This TOD Deed is Revocable Before my death, I have the right to revoke this deed. Page 1 of 3