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CASH <br />CHECK :1 r[.[ <br />REFUNDS: <br />CASH <br />N CHECK <br />� RECORDED <br />,HALL COUNTY NE <br />'NST Z!5 o 3 b cit 4E5JUL -8 A'Ob <br />MST! WOLD <br />REGISTER OF DEEDS <br />/R eturn to: <br />Zachary Butz <br />308 N. Locust, Ste. 501 <br />Grand Island, NE 68801 <br />Space Above Line Reserved for Recording Purposes <br />REVOCABLE TRANSFER ON DEATH DEED <br />a2; <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 <br />in which the property is located within 30 days after it was signed. If either of these requirements <br />is not met, this form will not be effective. <br />Identifying Information about Owner(s) <br />Name of Owner <br />BARBARA A. ARMSTRONG <br />CARLSON, f/k/a BARBARA A. <br />CARLSON <br />4511 CALVIN DR. <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 />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 Five (5), Lake Davis Acres Second Subdivision, Hall County, Nebraska <br />Transfer on Death Deed - Page No. 1 <br />