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202500264 (9), WEST OF THE 6TH P.M. EXCEPTING THEREFROM A TRACT OF LAND CONVEYED TO THE STATE OF NEBRASKA RECORDED IN THE REGISTER OF DEEDS OFFICE, HALL COUNTY, NEBRASKA, AS DOCUMENT NO. 80- 006669, AND EXCEPT A TRACT OF LAND MORE PARTICULARLY DESCRIBED IN WARRANTY DEED RECORDED AS DOCUMENT NO. 83- 003699 IN THE REGISTER OF DEEDS OFFICE, HALL COUNTY, NEBRASKA Primary Beneficiaries: I designate the following beneficiary of this revocable transfer on death deed if the beneficiary survives me. Name of Primary Beneficiary Mailing Address of Primary Beneficiary JEREMY HUSEN 10615 S. 191' Ave. Omaha, NE 68136 TIMOTHY HUSEN 360 E. Whitson St. Manhattan, IL 60442 Transfer on Death At my death, I transfer my interest in the described property to the beneficiary as designed above. The transfer occurs at the death of the Transferor. Survivorship Required Under Nebraska law, the interest of a designed beneficiary is contingent on the designated beneficiary surviving the transferor by one hundred twenty hours. This TOD Deed is Revocable Before my death, I have the right to revoke this deed. Required Warnings in the TOD Deed: Please pay close attention to the following warnings. Warning: The property transferred remains subject to inheritance taxation in Nebraska to the same extent as if owned by the transferor at death. Failure to timely pay inheritance taxes is subject to interest and penalties as provided by law. Warning: The designed beneficiary is personally liable, to the extent of the value of the property transferred, to account for Medicaid reimbursement to the extent necessary to discharge any such claim remaining after application of the assets of the transferor's estate. The designated beneficiary may also be personally liable, to the extent of the value of the property transferred, for claims against the estate, statutory allowances to the transferor's surviving Page 2 of 4