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D FDz <br />A <br />• • <br />z -z <br />c... ,_ <br />c. FN - z A G) <br />B� z, <br />m , z <br />, z <br />cm a,CS� <br />00 <br />Iii€ 2Olb 0bLI LIy <br />Return to <br />Mary J. Livingston <br />P 0 Box 1563 <br />Grand Island NE 68802 <br />CASH <br />CHEC <br />Rom <br />REFUNDS:_ <br />CASH <br />t <br />HALL _'JP,' NE <br />1M1b 0: } — 8 ID 2: 29 <br />REGISTER OF DEEDS <br />TRANSFER ON DEATH � � ,%, 6p <br />PURSUANT TO NEBRASKA UNIFORM REAL PROPERTY TRANSFER ON <br />DEATH ACT <br />I, Patricia J. Wisely, now known as Patricia J. Foster, a single person, Grantor/Transferor, <br />transfer all of my interest in the following described property to the named beneficiary, Jon Evan <br />Wisely Ensley. Said transfer to be effective at my death. The real estate (as defined in Neb. <br />Rev. Stat. 76-201) in Hall County, Nebraska is described as follows: <br />Lot Nine (9), Block Twenty (20), Fairview Park Addition, City of Grand Island, Hall <br />County, Nebraska. <br />Also known as 1008 W 8th Street, Grand Island, Nebraska. <br />I may revoke this deed. When recorded, this deed revokes any Transfer on Death deed <br />that I made before signing this deed. <br />Executed: OcsroL6 i � , 2026. <br />WARNING: The property transferred remains subject to inheritance taxation in Nebraska <br />to the same extent as if owned by the transferor at death. Failure to timely pay inheritance taxes <br />is subject to interest and penalties as provided by law. <br />WARNING: The designated beneficiary is personally liable, to the extent of the value of <br />the property transferred, to account for medicaid reimbursement to the extent necessary to <br />discharge any such claim remaining after application of the assets of the transferor's estate. The <br />designated beneficiary may also be personally liable, to the extent of the value of the property <br />transferred, for claims against the estate, statutory allowances to the transferor's surviving spouse <br />and 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 <br />this deed by a transferor, a transferor's spouse, or both a transferor and the transferor's spouse in <br />order to qualify or remain qualified for medicaid assistance. <br />I, Patricia J. Wi ly, now known as Patricia J. Foster, the transferor, sign my name to this <br />instrument this 'ay of -t-�$�,� 2026, and being first duly sworn, do hereby <br />declare to the undersigned authority that I sign and execute this transfer on death deed to transfer <br />my interest in the described real property and that I sign it willingly or willingly direct another <br />to sign for me, that I execute it as my free and voluntary act for the purposes therein expressed, <br />that I am eighteen years of age or older or am not at this time a minor and that I am of sound <br />mind and under no constraint or under influence. <br />POJK.( . <br />Patricia J. Foster, feror <br />Tr <br />