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202404349 transferor's surviving spouse and children, and the expenses of administration to the extent needed to pay such amounts by the personal representative. Warning: The Department of Health and Human Services may require revocation of this deed by a transferor, a transferor's spouse, or both a transferor and the transferor's spouse in order to qualify or remain qualified for Medicaid assistance. Signature of Owner Making This Transfer on Death Deed I, Sharre K. Jande, the transferor, sign my name to this instrument on 5e phmber' 2 , 2024, and being first duly sworn, do hereby declare to the undersigned authority that I signed and executed this transfer on death deed to transfer my interest in the described real property and that I signed it willingly or willingly directed another to sign for me, that I executed it as my free and voluntary act for the purposes therein expressed, that I am eighteen years of age or older or am not at the this time a minor, and that I am of sound mind and under no constraint or undue influence. We, M's)1.41:1.5 O .aa/i/Le tiatk/4 Sharre K. Jande Transferor and 6 /or.: g Iz, Gil(' , the witnesses, signed our names to this instrument, being first duly sworn, and do hereby declare to the undersigned authority that the transferor signed and executed this transfer on death deed to transfer her interest in the described real property and that she signed it willingly or willingly directed another to sign for her, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of us, in the presence and hearing of the transferor, hereby signed this deed as witness to the transferor's signing, and that to the best of our knowledge the transferor is eighteen years of age or older or is not at the time a minor and the transferor is of sound mind and under no constraint or undue influence. maAl iAiN, Witness s s too &•�1y Witness' Address is4A 644\ Witness Address ) o S .�