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202402958 <br />Legally Required Warnings in the TOD Deed: <br />Please pay close attention to the following warnings. <br />Warning: <br />The property transferred remains subject to inheritance taxation in Nebraska to the same <br />extent as if owned by the transferor at death. Failure to timely pay inheritance taxes is <br />subject to interest and penalties as provided by law. <br />Warning: <br />The designated beneficiary is personally liable, to the extent of the value of property <br />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 <br />designated beneficiary may also be personally liable, to the extent of the value of the <br />property transferred, for claims against the estate, statutory allowances to the transferor's <br />surviving spouse and children, and the expenses of administration to the extent needed to <br />pay such amounts by the personal representative. <br />Warning: <br />The Department of Health and Human Services may require revocation of this deed by a <br />transferor, a transferor's spouse, or both a transferor and the transferor's spouse in order <br />to qualify or remain qualified for Medicaid assistance. <br />Signature of Owners Making This Transfer on Death Deed <br />1, Valerie D. McKay Fischer, the transferor, sign my name to this instrument on _June 27, <br />2024 and being first duty sworn, do herby declare to the undersigned authority that 1 sign and <br />execute this transfer on death deed to transfer my interest in the described real property and that 1 <br />sign it willingly or willingly direct another to sign for me, that I execute it as my free and voluntary <br />act for the purposes therein expressed, that I am eighteen years of age or older or am not at this <br />time minor, an. hat I am of sound mind and der no constraint or undue influence. <br />Valerie D. McKay Fisc r, Transferor <br />Warning: The two witnesses must be disinterested for this Deed to be valid. An interested <br />witness means any individual who, on the date of this deed, is or would be entitled to receive <br />any interest in the land under this transfer on death deed if the transferors died under the <br />circumstances existing at the date of the signing of this deed, or any child, spouse, or heir of <br />that person. <br />We, hQrC,f1 R.octas and an10n Buftle Icascn , the <br />witnesses, sign our names to this document, being first duly sworn, and do hereby declare to the <br />undersigned authority that the transferors sign and execute this transfer on death deed to transfer <br />their interest in the described real property and that they sign it willingly or willingly direct <br />another to sign for them, and that they execute it as their free and voluntary act for the purposes <br />therein expressed, and that each of us, in the presence and hearing of the transferors, hereby <br />signs this deed as witness to the transferors' signing , and that to the best of his or her knowledge <br />the transferors are eighteen years of age or older or are not at this time minors and the transferors <br />are of sound mind and under no constraint or undue influence. <br />_ 111 N oat4 sT GI NE 68go ) <br />rtness Witness Address <br />0-)/� 1 SLC (U�UL-) 1))91 c .use , I N� <br />Witness Witness Address Log0 I <br />Page 2 of 4 <br />