Space Above Line Reserved for Recording Purposes

Space Above Line Reserved for Recording Purposes

REVOCABLE TRANSFER ON DEATH DEED

(More than One Owner)

Notice to Owners

You should each carefully read all information on this form. You May Want to Consult a Lawyerbefore Using This Form.

This form must be recorded with the Register of Deeds of the County in which the property is located before your death and it also must be recorded with the Register of Deeds of the County in which the property is located within 30 days after it was signed. If either of these requirements is not met, this form will not beeffective.

Identifying Information about Owner(s)

Name of Owner / Mailing Address of Owner
[Name of Owner 1] / [Street Address Owner 1] [City State Zip Owner 1]
[Name of Owner 2] / [Street Address Owner 2] [City State Zip Owner 2]

Notice to Register of Deeds

This is a transfer on death deed and Form 521 is not required with the filing of this Transfer on Death deed under Neb. Rev. Stat. §76-214(2)(b).

Legal Description

The following real estate is transferred by this document, effective at the death of the survivor of theOwnerstothePrimaryBeneficiary ortotheAlternateBeneficiaryasprovidedbelow.

[Legal Description Goes Here]

Primary Beneficiary

We designate the following beneficiary of this revocable transfer on death deed if the beneficiary survives the survivor of us.

Name of Primary Beneficiary / Mailing Address of Primary Beneficiary
[Name of Primary Beneficiary] / [Street Address Primary Beneficiary] [City State Zip Primary Beneficiary]

Alternate Beneficiary

If our primary beneficiary does not survive us, we designate the following alternate beneficiary if that alternate beneficiary survives the survivor of us.

Name of Alternate Beneficiary / Mailing Address of Alternate Beneficiary
[Name of Alternate Beneficiary] / [Street Address Alternate Beneficiary] [City State Zip Alternate Beneficiary]

Transfer on Death

At the death of the survivor of us, we transfer our interest in the described property to the beneficiaries as designated above. The transfer occurs at the death of the survivor of the Transferors.

Survivorship Required

Under Nebraska law, the interest of a designated beneficiary is contingent on the designated beneficiary surviving the survivor of the transferors by one hundred twenty hours.

This TOD Deed is Revocable

Before our death, we (or the survivor of us) have the right to revoke this deed.

Growing Crops

If this land is agricultural land the growing crops shall pass to:

The primary or alternate beneficiary

The estate of the survivor of us.

We understand that if we make no choice growing crops pass to the estate of the survivor of us.

Legally Required Warnings in the TOD Deed:

Please pay close attention to the following warnings.

Warning:

The property transferred remains subject to inheritance taxation in Nebraska to the same extent as if owned 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 last surviving transferor’s 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 last- surviving transferor’s surviving spouse and children,and the expenses of administration to the extent needed to pay such amounts by the personalrepresentative.
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 Medicaidassistance.
Signature of Owners Making This Transfer on Death Deed
We [Name of Owner 1] and [Name of Owner 2], the transferor(s), sign our names to this instrumenton, 2013, and being first duly sworn, do hereby declare to the undersigned authority that we sign and execute this transfer on death deed to transfer our interest in the described real property and that we sign it willingly or that one or both of us willingly direct another to sign for that signer or signers, that we execute it as our free and voluntary act for the purposes therein expressed, that we are eighteen years of age or older or are not at this time a minor, and that We are of sound mind and under no constraint or undue influence.

[Name ofOwner1][Name of Owner2]
TransferorTransferor
Warning: The two witnesses must be disinterested for this Deed to be valid. Interested witness means any individual who on the date that this deed is or would be entitled to receive any interest
in the land if the transferors died under the circumstances existing at the date of the signing of thisdeed.
We,and, the witnesses, sign our names to this instrument, being first duly sworn, and do hereby declare to the undersigned authority that the transferors sign and execute this transfer on death deed to transfer their interest in the described real property and they sign it willingly or either or both of them willingly directs another to sign for either or both of them, and that they execute it as their free and voluntary act for the purposes therein expressed, and that each of us, in the presence and hearing of the transferors, hereby signs this deed as witness to the transferors’ signing, and that to the best of his or her knowledge the transferors are eighteen years of age or older or are not at this time minors and the transferors are of sound mind and under no constraint or undue influence.

Witness’NameWitness’Address

Witness’NameWitness’Address
Transfer on Death Deed - Page No. 3

Acknowledgement

State of Nebraska / )
) ss.
County of Douglas / )

Subscribed, sworn to, and acknowledged before me by [Name of Owner 1] and by [Name of Owner2],thetransferors,andsubscribedandsworntobeforemeby _____ and ,witnesses,on ,2013.

Notary Public

[Seal]My CommissionExpires

COMMON QUESTIONS ABOUT THE USE OF THIS FORM

What does the Transfer on Death (TOD) deed do?

When you die, this deed transfers the described property, subject to any liens or mortgages (or other encumbrances) on the property at your death. Probate is not required. The TOD deed has no effect until you die. You can revoke it at any time. You are also free to transfer the property to someone else during your lifetime. If you do not own any interest in the property when you die, this deed will have noeffect.

Can I change a Transfer of Death Deed by My Will?

No. It can only be changed by a revocation that is recorded in the Register of Deeds office within 30 days of it being signed and before your death. If the property is sold and a deed recorded the Transfer on Death deed is automatically revoked.

How do I make a TOD deed?

Complete this form. Have it signed by two witnesses, who together with you all appear before a notary public and have it acknowledged before the notary public or other individual authorized by law to take acknowledgments. Record the form in each county where any part of the property is located. The form has no effect unless it is acknowledged and recorded before your death and unless recorded within 30 days of being signed. If the property is located in more than one county you may want to sign one form for each county so that the 30 day requirement can be met.

Is the “legal description” of the property necessary?

Yes.

How do I find the “legal description” of the property?

This information may be on the deed you received when you became an owner of the property. This information may also be available in the office of the county register of deeds for the county where the property is located. If you are not absolutely sure, consult alawyer.

Can I change my mind before I record the TOD deed?

Yes. If you have not yet recorded the deed and want to change your mind, simply tear up or otherwise destroy the deed.

How do I “record” the TOD deed?

Take the completed and acknowledged form to [the office of the county register of deeds of the county where the property is located. Follow the instructions given by the county register of deeds to make the form part of the official property records. If the property is in more than one county,youshouldrecordthedeedineachcountyorhaveaseparateformforeachcounty.

Can I later revoke the TOD deed if I change my mind?

Yes. You can revoke the TOD deed. No one, including the beneficiaries, can prevent you from revoking the deed.

How do I revoke the TOD deed after it is recorded?

There are three ways to revoke a recorded TOD deed: (1) Complete and acknowledge a revocation form in a similar fashion to what is done for the original transfer on death deed, and record it in each county where the property is located. (2) Complete and acknowledge a new TOD deed that disposes of the same property, and record it in each county where the property is located. (3) Transfer the property to someone else during your lifetime by a recorded deed that expressly revokes the TOD deed. You may not revoke the TOD deed bywill.

I am being pressured to complete this form. What should I do?

Do not complete this form under pressure. Seek help from a trusted family member, friend, or lawyer.

Do I need to tell the beneficiaries about the TOD deed?

No, but it is recommended. Secrecy can cause later complications and might make it easier for others to commit fraud.

What if I want to later put a deed of trust on this property?

You can do this. A beneficiary takes the property subject to all conveyances, encumbrances, assignments, contracts, mortgages, liens, and other interests to which the property is subject at yourdeath.It doesnotmatterwhetheritisdone beforeorafteryourecordthisform.

I have other questions about this form. What should I do?

This form is designed to fit some but not all situations. If you have other questions, you are encouraged to consult a lawyer.

OPTIONAL PROVISIONS FOR TOD DEED

Change to Allow Alternate Beneficiary to Take Instead of Other Primary Beneficiary Remember that if there are two or more primary beneficiaries that the presumption that if one of them does not survive the transferor means that the other primary beneficiaries share the share belonging to the deceased primary beneficiary. If you want to do so you can alter that in the TOD deed by using something like thefollowing:

We intend that if any primary beneficiary of any share below does not survive us that the alternate beneficiary for that share shall receive the share of that primary beneficiary rather than the other primary beneficiary orbeneficiaries.

First Share

Primary Beneficiary

We designate the following beneficiaryofa% (or use a fraction) share of the real estate covered by this revocable transfer on death deed if the beneficiary survivesus.

Name of Primary Beneficiary / Mailing Address of Primary Beneficiary
[Name of Primary Beneficiary] / [Street Address Primary Beneficiary] [City State Zip Primary Beneficiary]

Alternate Beneficiary

If our primary beneficiary named immediately above does not survive us, we designate the following alternate beneficiary for the share of the primary beneficiary named immediately aboveifthatalternatebeneficiarysurvivesus.(Optional.)Addasecondaryalternatebeneficiary.

Name of Alternate Beneficiary / Mailing Address of Alternate Beneficiary
[Name of Alternate Beneficiary] / [Street Address Alternate Beneficiary] [City State Zip Alternate Beneficiary]

*Repeat the above as many times as needed

Dealing with Minors

If dealing with a potential minor beneficiary, the recommended solution is to use a trustee of a trust as the beneficiary. A trust is recommended, particularly when there may be additional children due to the potential title issues that could arise in establishing who are the children when there are after-born or after-adopted children. This can be handled by the trustee without affecting title to realestate.

However, if a specific trust is not to be used, perhaps a custodian under UTMA such as the following could be used:

Alternate Beneficiary

If our primary beneficiary named immediately above does not survive us, we designate the following alternate beneficiary for the share of the primary beneficiary named immediately above if that alternate beneficiary survivesus.

Name of Alternate Beneficiary / Mailing Address of Alternate Beneficiary
[Name of Custodian] as custodian under the Nebraska Uniform Transfers to Minors Act for [Name of Alternate Beneficiary], a Minor. If [Name of Alternate Beneficiary] has reached age 21, then to [Name of AlternateBeneficiary]
If [Name of Custodian] is unable or unwilling to serve as custodian, then [Name of Alternate Custodian] shall be the custodian. / [Street Address Alternate Beneficiary] [City State Zip Alternate Beneficiary]