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:n to: <br />Ronald S. Depue <br />308 N. Locust, Ste. 501 <br />Grand Island, NE 68801 <br />CASH <br />CHECK <br />REFUNDS: <br />CASH <br />CHECK <br />REC .. � <br />HALL ¢"! N E <br />IHST 20211 02uU5 20211JUN a- tis 25 <br />REGISTER OF OE DEEDS <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 />MARNELL L. VANHOOSEN 1604 GRAND AVE. <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 />Lot Four (4) in Block Two (2) in Country Club Subdivision, being a part of the East <br />One -Half (E'/z) of Northwest Quarter (NW'/4) of Section Twenty-eight (28), <br />Township Eleven (11) North, Range Nine (9), West of the 6th P.M., Hall County, <br />Nebraska <br />Transfer on Death Deed - Page No. 1 <br />