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CASH <br />CHECK L1o°° <br />A , U ,i <br />es HALL .1.:TFY NE <br />co <br />w - .r <br />�■ III;: � 7. Th 0 h G 3 ?t: 13 <br />REFUNDS: <br />CASH <br />CHECK <br />Return to <br />Galen E. Stehlik <br />724 W. Koenig Street <br />Grand Island NE 68801 <br />C C S C. DEEDS <br />TRANSFER ON DEATH DEED <br />PURSUANT TO NEBRASKA UNIFORM REAL PROPERTY TRANSFER ON <br />DEATH ACT <br />1Cpco <br />I, June A. Bartek, a single person, Grantor/Transferor, transfer all of my interest in the <br />following described property to Teresa R. McDonald. Said transfer to be effective at my death. <br />The real estate (as defined in Neb. Rev. Stat. §76-201) in Hall County, Nebraska is described as <br />follows: <br />Unit Thirteen (13), Westwood Park I Condominiums, a condominium in the City of Grand <br />Island, Hall County, Nebraska. <br />I may revoke this deed. When recorded this deed revokes any Transfer on Death deed that <br />I made before signing this deed. <br />Executed: q - ig - , 2026. <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 />WARNING: Property insurance on the transferred property may expire thirty days after the <br />death of the transferor. Unless the transferor has added the designated beneficiary as an insured <br />or additional named insured to the property insurance policy of the transferred property, any <br />property insurance coverage of the transferred property will end on the earliest to occur of the <br />following after the transferor's death: The end of the policy period as determined as if the <br />transferor was still living; the date the designated beneficiary obtains alternative coverage; or <br />thirty days after the transferor's death only if any premium required for the additional days <br />beyond the policy period is paid. <br />