Form No. — Transfer on Death Deed — Page 1 of 2 © 2011-2026 Stevens-Ness Law Publishing Co. Portland, OR  www.stevensness.com

LS - NO PART OF ANY STEVENS-NESS FORM MAY BE REPRODUCED IN ANY FORM OR BY ANY ELECTRONIC OR MECHANICAL MEANS. gi
2026-002181

Klamath County, Oregon

29

Q"' (=N \QJ’\Q_. D c\wucce 003538582026000218100200

1409 Yaa NedSs. Pos. 03/11/2026 02:42:45 PM Fee: $92.00

Blama™n  Eal\s Oveyen
ATEo
Until requested otherwise, send all tax statements to

(Name and Address):

Peturned at Counter

Alawa

After recording, return to (Name and Address): I

91 bo) [SPACE RESERVED FOR RECORDER'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

L Qeavlema. Oc\occen

, owner of the real

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 klowmy o
County, State of Oregon, legally described (check one): 0 as set forth on the attached Exhibit A, and incorporated by this reference;

XJ as follows:
Lot \La‘\j and \R R\ock 27, MHUNTAIN VIEW ADDITION
Fothe QTY 06 Klamath Falls, atcor dm o the
ofL icha\ P\al Yore o€ on $i\e “vv Phe o%\?.c& of Hhe
COU"\’\‘\ A\v . oL K lavwiodWN Covvx ,Qre_lov\,

Tox Accovn NO,LR01-020PD~ 02900 ~go o

Key WO (72799

T designate

Anthony Delvcca ,
whose mailing address, if available, is

__________________________ L?_Q__a____vj&'!_\___Ng-.g_-g___?_u&___“S_\_g_\\_’_‘f\_s&t‘_’)___‘—EE\L‘:_S__*-,QJ_‘_Q?,‘O__ .
as my primary beneficiary* if that person survives me. <« b 0|

(Optional) I designate _Q_Q st Do L <O

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

*ORS 93.961(2) requires that the beneficiary or beneficlaries 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 aiternate beneficiaries if the primary beneficiary or beneficiaries 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 transter
equal shares with no right of survivorship when muitiplie beneficiaries are named (93.969); (b) Are always revocable (93.855); (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. - Transfer on Death Deed — Page 2 of 2 ®© 2011-2026 Stevens-Ness Law Publishing Co. Portland, OR  www.stevensness.com

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

4 Rt

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

(Optional) SPECIAL TERMS:

O (Check if applicable.) This deed revokes the prior transfer on death deeddated .. ________________ I
andrecordedon _____.______________________________ , as Document No. ____ N e in the Records
of County, Oregon

In construing this instrument, the singular includes the plural.

IN WITNESS WHEREQOF, the undersigned has executed this instrument on _ ___QL_V_CJQ

This record was ledged before me on _NMavch 1l A
C(MU\L&J __________________________________________________________________

otary Pub}€ for Oregon
My commission expires _-g«nggg*i__g_é 2030 .

5‘" 7N OFFICIAL STAMP
@ ’_‘, BRANDY NICOLE CARL REEVES
NOTARY PUBLIC - OREGON
COMMISSION NO. 1064792
MY COMMISSION EXPIRES JANUARY 05, 2030