Form No. - Transfer on Death Deed — Page 1 of 2 © 2011-2025 Stevens-Ness Law Publishing Co. Portland, OR  www.stevensness.com

LK NO PART OF ANY STEVENS-NESS FORM MAY BE REPRODUCED IN ANY FORM OR BY ANY ELECTRONIC OR MECHANICAL MEANS. o
2026-000009 o
Returned at Counter Klamath County, Oregon

N f‘? 00351274202600000090020024

~ | ) v ‘
;_D'L L[ [ (V;\ (_‘C;?)___i @‘(Q { ?éso? ,{ 01/02/2026 10:00:32 AM ‘ Fee: $92.00
K oot Hs 1 Orerd 760 |

Until requested otherwise, send all ta;ftatements to

After recording, return to (Name and gdress):

s

( and Addrgss): Y ///
Batlam . Dnud i 1

- -4-/——6&ec?-5p?+’n} Q?" s

Kl etk Gy O 776p!

[SPACE RESERVED FOR RECCORDER'S USE]

NOTICE TO OWNER: YOU SHOULD CAREFULLY READ ALL INFORMATION ON THIS FORM. YOU MAY WANT TO CONSULT A LAWYER BEFORE USING THIS
FORM. THIS FORM MUST BE RECORDED BEFORE YOUR DEATH OR IT WILL NOT BE EFFECTIVE. (TYPE OR LEGIBLY PRINT ALL INFORMATION.)

TRANSFER ON DEATH DEED

NI DO R B T 7777t AL ) = S —
“““““““““““ T ?Wé\JHK‘?&*‘J‘S‘"‘ IR FAEE

property described below, upon my death, do hereby transfer to the beneficiary designated below, all of my right, interest and title in
that certain real property, with all rights and interests belonging or relating thereto, situated in __£_ L Ca s e-Tfne -
%unty. State of Oregon, legally described (check one): [ as set forth on the attached Exhibit A, and incorporated by this reference;

as follows: - .
CODE/ O7L  Pelieoo . A RCS -0

Mmap 3189 —pa A0~ 00 .
Legal | Mot meaped (a-\ L

I designate A;MGC %UV\\O) bdr/ ,
W??fff%”?ffff_ff;%,\{%A,A_"5_'__?__;,K__e_m;;!?&/g----dfc,__?].ég_,l

as my prifnary benef ary* 1f that person s

____________________________________________________________________________________________________________________________________

as my alternate beneficiary** if that person survives me.

*ORS 93.961(2) requires that the beneficiary or beneficiaries must be specifically identified by name, rather than as part of a class.

**ORS 93.953(2) states that an Individual may designate one or more alternate beneficiaries If the primary beneficiary or beneficlaries are not qualified to take the
property at the time of death or do not survive the transferor.

PUBLISHER'S NOTE: ORS chapter 93 provides that Transfer on Death deeds: (a) Transfer only property that the transferor still owns at time of death, and transfer
equal shares with no right of survivorship when multiple beneficiaries are named (93.969); (b) Are always revocable (93.955); (c) Must be recorded before death
to be effective (93.961), but do not need to be delivered to designated beneficiaries (93.963); (d) Transfer property without any warranties or covenants of title
and subject to the debts of the decedent as well as any liens, mortgages and/or other interests to which the property is subject at time of death (93.969).

Form No. - Transtfer on Death Deed — Page 2 of 2

© 2011-2025 Stevens-Ness Law Publishing Co.  Portland, OR  www.stevensness.com

LK

NO PART OF ANY STEVENS-NESS FORM MAY BE REPRODUCED IN ANY FORM OR BY ANY ELECTRONIC OR MECHANICAL MEANS.

Rl

Before my death, I have the right to revoke this deed.

(Optional) SPECIAL TERMS: __ f\/_ @ /(/Zi— ______________________________________________________________________

STATE OF OREGON, County of .. X\amayvy ) ss.
This record was agknowledged before me on __m O b’_QE____\_\__L_’LQQ.fi ___________ ,
by . David _nicheel _ Gyaneea .

Notary Public for Oregon \>
OFFICIAL STAMP issi i K\f, Y

rnCAL STAMP My commission expires ¥ ____L)Qg\(_&_?.[)_-?za -----
NOTARY PUBLIC - OREGON
COMMISSION NO. 10452794

MY COMMISSION EXPIRES FEBRUARY 27, 2028