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CASH CHECK /6 ,t d REFUNDS: CASH CHECK ON) cii RECORDED C°� HALL COUNTY NE 0 N= INST 2025 0 b o 0 2 1015 DEC - P 2: 08 Please return to: John Diamantis Heritage Law, P.C., L.L.O. 1309 S 204t° St, #136 Elkhorn, NE 68022 (402) 915-1039 REVOCABLE TRANSFER ON DEATH DEED TRANSFEROR GWENDOLYN BAMESBERGER 1740 Superior St, Rm 13 Lincoln, NE 68521 LEGAL DESCRIPTION Lot Twenty -One (21), in Block Six (6), in Morris Third Addition, an Addition to the City of Grand Island, Hall County, Nebraska. PRIMARY BENEFICIARY(IES) BREE A. ROSCHEWSKI BRITTON R. BAMESBERGER At my death, I transfer my interest in the described property to the beneficiaries as designated above. Before my death, I have the right to revoke this deed. WARMNG: The property transferred remains subject to inheritance taxation in Nebraska to the same extent as if awned by the transferor at death. Failure to timely pay inheritance taxes is subject to interest and penalties as provided by law WARNING: The designated 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 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 spouse and children, and the expenses of administration to the extent needed to pay such amounts the by the personal representative. WARNING: The Department of Health and Human Services may require revocation of this deed by a transferor, a transferor's spouse, or both a transferor and the transferor spouse in order to quatify or remain qualified for Medicaid assistance. WARNING: Property insurance on the transferred property may expire thirty days after the death of the transferor. Unless the transferor has added the designated beneficiary as an insured or additional named insured to the property insurance policy of the transferred property, any property insurance coverage of the transferred property will end on the earliest to occur of the following after the transferor's death: The end of the policy period as determined as if the transferor was still living; the date the designated beneficiary obtains alternative coverage; or thirty days after the transferor's death only if -any premium required for the additional days beyond the policy period is paid. I, WENDOLLN BAMESBERGER, sign my name to this instrument on QV' ( I , 2025, and being first duly sworn, do hereby declare to the undersigned authority that I sign and execute this transfer on death deed to transfer my interest in the described real property and that I sign it willingly or willingly direct 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 and I am not at this time a minor :and\that t am of sound mind and under no constraint or undue influence. KfZiS 1-1 1,/OLD REGISTER OF DEEDS