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20240430; <br />transferor's surviving spouse and children, and the expenses of administration to the extent <br />needed to 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 to <br />qualify or remain qualified for Medicaid assistance. <br />Signature of Owners Making This Transfer on Death Deed <br />We, RANDAL SWANEK, A/K/A RANDAL J. SWANEK, AND CINDY S. SWANEK, the <br />transferors, sign our names to this instrument on S„ , 2024, and being first duly <br />sworn, do hereby declare to the undersigned authority that we sign and execute this transfer on death <br />deed to transfer our interest in the described real property and that we sign it willing or that one or <br />both of us willingly direct another to sign for that signer or signers, that we execute it as our free and <br />voluntary act for the purposes therein expressed, that we are eighteen years of age or older or are not <br />at this time a minor, and that we are of sound mind and under no constraint or undue influence. <br />RANDAL SWAN Transferor <br />A/k/a RANDAL J. SWANEK <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 that this deed is or would be entitled to receive <br />any interest in the land under this transfer on death deed if the transferor died under the <br />circumstances existing at the date of the signing of this deed or any child, spouse or heir of that <br />person. <br />We, MO AO. Sc, P O 1) and ):%W1)/1.471T-4- , the <br />witnesses, sign our names to this instrument, 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 their <br />interest in the described real property and that they sign it willingly or either or both of them <br />willingly directs another to sign for either or both of them, and that they execute it as their free and <br />voluntary act for the purposes therein expressed and that each of us, in the presence and hearing of <br />the transferors, hereby signs this deed as witness to the transferors' signing, and that to the best of <br />his or her knowledge the transferors are eighteen years of age or older or are not at this time minors <br />and the transferors are of sound mind and under no constraint or undue influence. <br />Page 3 of 4 <br />