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CASH <br />CHECK / CIO <br />: coding Law LLC <br />PO Box 5627 <br />V Grand Island, NE 68802 <br />REFUNDS: <br />CASH <br />CHECK <br />RECORDED NE <br />HALL COI IrITY <br />MST 21324 OSSlb 1024NOV -I P 2:53 <br />� iS T 1 WOO <br />REGISTER OF DEEDS <br />REVOCABLE TRANSFER ON DEATH DEED <br />(Single Owner) <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. This form must be recorded with the Register of Deeds of the County in which <br />the property is located before your death, and it also must be recorded with the Register of Deeds <br />of the County in which the property is located within 30 days after it was signed. If either of <br />these requirements is not met, this form will not be effective. <br />Identifying Information about Owner: <br />BonnieJean Kool, also known as Bonnie Jean Kool <br />4253 Spur Lane <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 <br />the Primary Beneficiary or to the Alternate Beneficiary as provided below. <br />Lot Sixteen (16), Western Heights Third Subdivision, Hall County, Nebraska <br />Primary Beneficiary <br />I designate the following beneficiaries, in equal shares as tenants in common, of the real estate <br />covered by this revocable transfer of death deed: <br />Tina M. Marler, 1890 Kilbirnie Dr., Germantown TN 38139 <br />Todd M. Kool, 1112 South Pleasant View, Grand Island NE 68801 <br />Brian M. Kool, 4300 W Waco Drive, Ste B2-402, Waco TX 76710 <br />Bradley M. Kool, 1925 4th Avenue, Boelus NE 68820 <br />Brent M. Kool, 2139 Ashwood Ave., Papillion NE 68133 <br />Transfer on Death <br />At my death, I transfer my interest in the described property to the beneficiaries as designated <br />above. The transfer occurs at the death of the Transferor. <br />Survivorship Required <br />Under Nebraska law, the interest of a designated beneficiary is contingent on the designated <br />beneficiary surviving the transferor by one hundred twenty hours. <br />This TOD Deed is Revocable <br />Before my death, I have the right to revoke this deed. <br />Legal Warnings: <br />Please pay close attention to the following warnings: <br />A. The property transferred remains subject to inheritance taxation in Nebraska to the <br />1 <br />