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CASH <br />CHECK <br />INS202q 0 5 2 I 2 <br />REFUNDS:_ <br />CASH. <br />CHECK, <br />DED <br />HALL Cr'''1 N NE <br />202U cc' ? A II: 24 <br />W C LD <br />REGISTER OF DEEDS <br />Return to: <br />/ John B. McDermott <br />,V/ 308 N. Locust Ste 501 <br />Grand Island, NE 68801 <br />REVOCABLE TRANSFER ON DEATH DEED <br />,se° <br />Notice to Owner <br />You should carefully read all information on this form. You May Want to Consult a Lawyer before <br />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 />JUDITH L. McCARTHY 1812 W. JOHN STREET <br />GRAND ISLAND, NE 68803 <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 Owner to the <br />Primary Beneficiary or to the Alternate Beneficiary as provided below. <br />LOT NINE (9), IN BLOCK FIFTY-THREE (53) IN CHARLES WASMER'S <br />SECOND ADD TION TO THE CITY OF GRAND ISLAND, NEBRASKA, <br />C OVrrr IJ C' EPP -R <br />Page 1 of 4 <br />