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INST 20211 0 U 3 0 5 <br />CASH <br />CHECK 9r J <br />REFUNDS: <br />CASH <br />CHECK <br />RECORDED <br />HALL COUNTY NE <br />MI SEP AII: 51 <br />r:dSTI WOLD <br />REGISTER OF DEEDS <br />Return to: <br />John B. McDermott <br />308 N. Locust Ste 501 <br />V Grand Island, NE 68801 <br />REVOCABLE TRANSFER ON DEATH DEED <br />foo <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 in <br />which the property is located within 30 days after it was signed. If either of these requirements is <br />not met, this form will not be effective. <br />Identifying Information about Owner(s) <br />Name of Owner <br />RANDAL SWANEK <br />A/K/A RANDAL J. SWANEK <br />CINDY S. SWANEK <br />Mailing Address of Owner <br />303 W. WALT AVENUE <br />DONIPHAN, NEBRASKA 68832 <br />303 W. WALT AVENUE <br />DONIPHAN, NEBRASKA 68832 <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 the <br />Owners to the Primary Beneficiary or to the Alternate Beneficiary as provided below. <br />Page 1 of 4 <br />