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Prepared By: / <br />Name: ✓Tr( ii il,-i!r <br />Address: 5/03 Sei )d CT <br />Ciet " d "VC f <br />CASH a a 'OD <br />CHECK_ <br />REFUNDS: <br />CASH <br />CHECK <br />r EGO AGED <br />HALL f' "TY NE <br />!ET ?0T!, 0 I b q 8 7026 MAF1 A I I: 40 <br />D <br />REGISTER OF DEEDS <br />Space above this line for recorder's use only <br />After Recording Return To: <br />Name: /�r/ntpi Nl`S��1I'e>- <br />Address:�_�/a . <br />`-iC } r NF P Play <br />11 <br />NEBRASKA TRANSFER ON DEATH DEED <br />TRANSFEROR INFORMATION. <br />Transferor Full Name: 1- it{ D, I-td S f ej a Marital Status: S + "Ty / <br />Address: 4103 .S'a tci Po 6oijon- t1°a t raAt/ - bt Ay <br />Transferor Full Name: <br />Address: <br />Marital Status: <br />Legal Description of Property: <br />ow, rb Sov+l, Love VI 'kg 4 uFt4 -4bb /11 lot►3)k 1 <br />No PI n D h 1° .A 11 k rket C I eon 4.e.et- e 4) Is1 pc k On eC I ), 4 v r-t ti ,A- d d i fi� v n <br />to OA\ rDi I4A11 enu fyl /l/ <br />[WRITE LEGAL DESCRIPTION HERE OR ATTACH EXHIBIT A] <br />BENEFICIARY. I designate the following beneficiary if the beneficiary survives me. <br />Full Name: nS1 1't 'CY Marital Status: I/ ; PcL <br />Address: II J-g / 5 l/ r vc Pagyp) 1/) dh 44. 6 1d'7 <br />ALTERNATE BENEFICIARY (OPTIONAL). If my primary beneficiary does not survive me, I <br />designate the following alternate beneficiary if that beneficiary survives me. <br />Full Name: a V 101- 0 S r' Marital Status: <br />Address: 1 ci a_1 .g e t r. Oct, hrb liT oh 95O02 <br />