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202600379 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's spouse in order to qualify 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. Signature of Owner Making This Transfer on Death Deed I, Bernard R. Konen, a single person, the transferor, sign my names to this instrument on :loin ;Z 7 , 2026, 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 or am not at this time a minor, and that I am of sound mind and under no constraint or undue influence. and R. onen, Transferor Warning: The two witnesses must be disinterested for this Deed to be valid. An interested witness means any individual who on the date that this deed is or would be entitled to receive any interest in the land under this transfer on death deed if the transferor died under the circumstances existing at the date of the signing of this deed or any child, spouse or heir of that person. We, Non°, ScJvo II 4the witnesses, sign our names to this instrument, being first duly swo , and do hereby declare to the undersigned authority that the transferor signs and executes this transfer on death deed to transfer his or her interest in the described real property and that he or she signs it willingly or willingly directs another to sign for him or her, and that he or she execute it as his or her free and and ri PI Transfer on Death Deed - Page No. 3