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201205248
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Last modified
9/10/2012 2:37:55 PM
Creation date
6/29/2012 9:12:00 AM
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DEEDS
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201205248
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201205248 <br />DURABLE POWER OF ATTORNEY <br />OF <br />Mary E. McGovern <br />I. PRINCIPAL AND ATTORNEY-IN FACT <br />I, Mary E. McGovern, who resides at 420 Woodland Drive, Grand Island, <br />Nebraska 68801, appoint the following person to serve as my attorney-in-fact, to <br />act for me in any lawful way with respect fi� the subjects indicated below. <br />Name: Patricia D. Schafer <br />Address: 3929 831'd Street <br />Colwnbus, Nebraska 1�601 <br />II. EFFECTPVE TIME <br />This Power of Attorney shall become effe�tive immediately, and shall not <br />be affected by any subsequent disa.bility or incapacity of the principal. This is a <br />Ilurable Power of Attorney. <br />��i <br />Pursuant fo the Heal.th Insurance Porl�bility and Accountability Act of <br />1996 (HIPAA) and any sinvlar state laws, and exclusively for fihe purpose o# <br />amaking a determination of my incapacitation or incapability of managing my <br />financial affairs and obtaining an affidavit of such incapacitation by a physician, I <br />aufihorize any health care provider to disclose to the person named herein as my <br />"attorney-in-fact," any pe�°tinent individually identifiable health information <br />sufficient to determ.ine whether I am by reason of illness or mental or physical <br />disability incapacita#ed or incapable of managing my financial affairs. In <br />exercising such authority, my attorney-in-fact shall constitute my'Personal <br />Representative' as defined by HLPAA. <br />82437%DOC2doc <br />
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