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202500047 claims against the estate, statutory allowances to the Owner's/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 an Owner/Transferor, an Owner's/Transferor's spouse, or both an Owner/Transferor and the Owner's/Transferor's spouse in order to qualify or remain qualified for Medicaid assistance. I, Sandra L. Hatheway, a single person, Owner/Transferor, sign my name to this instrument on the 3rd day of January, 2024, and being first duly sworn, do hereby declare to the undersigned authority that I sign and execute this Revocable Transfer on Death Deed to transfer my interest in the described real property and that I sign it willingly or willingly directs another to sign for me, that I execute 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 this time a minor, and that I am of sound mind and under no constraint or undue influence. Sandra L. Hatheway, Owner/Transferor 2 Warning: The two witnesses must be disinterested for this deed to be valid. Interested witness means any individual who on the date that this deed is executed is or would be entitled to receive any interest in the real property if the Owner/Transferor died under the circumstances existing at the date of the signing of this deed. We, to U' r 010)1 % )10- and K, i \ t the witnesses, sign ourinames to this instrument, being first duly sworn, and do hereby declare to the undersigned authority that the Owner/Transferor signs and executes this Revocable Transfer on Death Deed to transfer his or her interest in the described real property and he or she signs it willingly or willingly directs another to sign for him or her, and that he or she executes it as his or her free and voluntary act for the purposes therein expressed, and that each of us, in the presence and hearing of the Owner/Transferor, hereby signs this deed as witness to the Owner's/Transferor's signing, and that to the best of his or her knowledge the Owner/Transferor is eighteen years of age or older or is not at this time a minor and the Owner/Transferor is of sound mind and under no constraint or undue influence. Revocable Transfer on Death Deed Page 3