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CASH <br />CHECK 1(n °° <br />Return to <br />Galen E. Stehlik <br />P 0 Box 400 <br />Grand island NE 68802 <br />REFUNDS: <br />CASH <br />CHECK <br />,OrWED <br />HALL CO! i,, TY NE <br />JNST 7075 0 u U 1 1015 AUG 2 el P 2: 28 <br />r RiSTI WOLD <br />REGISTER OF DEEDS <br />162ao <br />TRANSFER ON DEATH DEED <br />PURSUANT TO NEBRASKA UNIFORM REAL PROPERTY TRANSFER ON <br />DEATH ACT <br />We, Chad W. Shriner and Tonya L. Shriner, husband and wife, Grantors/Transferors, <br />transfer all of our interest in the following described property to Daniel W. Shriner and Tyler M. <br />Shriner. Said transfer to be effective at our death. The real estate (as defined in Neb. Rev. Stat. <br />'76-201) in Hall County, Nebraska is described as follows: <br />Lot Twenty -One (21) in Reuting's Second Subdivision being a part of the Southwest <br />Quarter (SW 1/4) of Section Twenty -Four (24) in the Township Eleven (11) North, <br />Range Ten (10) West of the 6th P.M., in Hall County, Nebraska. <br />We may revoke this deed. When recorded this deed revokes any Transfer on Death deed <br />that we made before signing this deed. <br />Executed: August ) (' , 2025. <br />WARNING: The property transferred remains subject to inheritance taxation in Nebraska to the <br />same extent as if owned by the transferor at death. Failure to timely pay inheritance taxes is <br />subject to interest and penalties as provided by law. <br />WARNING: The designated beneficiary is personally liable, to the extent of the value of the <br />property transferred, to account for medicaid reimbursement to the extent necessary to discharge <br />any such claim remaining after application of the assets of the transferor's estate. The designated <br />beneficiary may also be personally liable, to the extent of the value of the property transferred, <br />for claims against the estate, statutory allowances to the transferor's surviving spouse and <br />children, and the expenses of administration to the extent needed to pay such amounts by the <br />personal representative. <br />WARNING: The Department of Health and Human Services may require revocation of this deed <br />by a transferor, a transferor's spouse, or both a transferor and the transferor's spouse in order to <br />qualify or remain qualified for medicaid assistance. <br />We, Chad W. Shriner and Tonya L. Shriner, husband and wife, the transferors, sign our <br />namea to this instrument this I 44h day of August, 2025, and being first duly sworn, do <br />hereby declare to the undersigned authority that we sign and execute this transfer on death deed <br />to transfer our interest in the described real property and that we sign it willingly or willingly <br />direct another to sign for us, that we execute it as our free and voluntary act for the purposes <br />therein expressed, that we are eighteen years of age or older or not at this time a minor and that <br />we am of sound mind and under no constraint or under influence. <br />ad W. Shriner, Transferor <br />4fruniA <br />Tonya L. S ner, Transferor <br />