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CASH <br />CHECK 2c ou <br />Return to: <br />INST 20211 0 5 0 1 1 <br />Clarence Eugene Hiegel <br />320 E. 19th Street, Grand Island, NE 68801 <br />TRANSFER ON DEATH DEED <br />REFUNDS: <br />CASH <br />CHECK <br />'RECORDED <br />HALL COUNTY NE <br />202UOCT ' A10:54 <br />iI 1 I WOLD <br />REGISTER OF DEEDS <br />Notice to Owner <br />This form must be recorded with the Register of Deeds of the County in which the <br />property is located within 30 days after it is signed, and before your death. If either of these <br />requirements are not met, this form will not be effective. <br />Identifying Information about Owner <br />Name of Owner Owner's Address <br />Clarence Eugene Hiegel 320 E. 19th street <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 />In accordance with the provisions of the NEBRASKA UNIFORM REAL PROPERTY <br />TRANSFER ON DEATH ACT, NEB. REV. STAT. §§ 76-3401 TO 76-3423 (the "Act"), Clarence <br />Eugene Hiegel (the "Transferor"), hereby states that upon the death of the Transferor, the following <br />described real estate (as defined in NEB. REV. STAT. § 76-201), shall be transferred to the <br />beneficiary or beneficiaries named herein: <br />Legal Description <br />LOT 22 IN BLOCK 6, MORRIS 3RD OF GRAND ISLAND, HALL COUNTY <br />NEBRASKA <br />