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CASH CHECK 2 .0 <br />5Z6E09Z0Z <br />Return to: <br />John B. McDermott <br />308 N. Locust Ste 501 <br />Grand Island, NE 68801 <br />REFUNDS: <br />CASHRE (FOS <br />HALL COUNT? Ng <br />INST 20Z5 0 3 9 2 S 1025.JUL 18 A 20 <br />KRIS `i'1 WOLD <br />REGISTER OF DEEDS <br />REVOCABLE TRANSFER ON DEATH DEED <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 />M. JEANNEE FOSSBERG <br />f/k/a M. JEANNEE MUELLER <br />403 E. 20th STREET <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 SIX (6), IN BLOCK NINE (9), MORRIS FIFTH ADDITION TO THE CITY <br />OF GRAND ISLAND, HALL COUNTY, NEBRASKA <br />Page 1 of 4 <br />