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. <br />�� �� <br />2012(1533� <br />they have the right to request, receive and review any information, verbai or written <br />regarding my physical or mental health including medical and hospital records and to <br />execute any releases or other documents thaf may be required in order to obtain <br />such information; to make health care decisions on my behalf including choice of <br />care and therapy, the selection of physicians, hospitals, and health care facilities; to <br />sign the necessary consents, re(eases, ciaims, insurance forms, and waivers; and to <br />make any and all decisions regarding the commencement or withdrawal of life <br />support measures; <br />i) To make appiication for bene�Fts or assistance through the Nebraska Department of <br />Health and Human Services or any other service; <br />j) Giving and granting unto the said attomey-in fact full power and authority to do and <br />perForm every aat and thing whatsoever requisite and necessary to be done in and <br />about the premises, as fully to all extent and purposes as I might or could do if <br />personally present, ratify and confirming all that said attorney-in-fact shall lawfully do <br />or cause to be done by virtue of these presents. <br />This power of attorney shall not be affected by disability of the undersigned principal, <br />and all aats done by the said attomey in fact hereunder shall have the same effect and inure <br />to the benefit of and bind myself, my heirs, devisees and persona( representa#ives. <br />IN WITNESS WHEREOF, I have hereunto set my hand and seal this 27th day of <br />November, 2007. <br />� s : /���, <br />Audrey S. D 's <br />STATE OF NEBRASKA ) <br />) :ss <br />COUNTY OF HALL ) <br />BE IT REMEMBERED that on the 27th day of November, 2007, before me the <br />undersigned, a Notary Public in and for said State, personally appeared Audrey S. Davis, to <br />me known to be the identical person described in and who executed the foregoing Power of <br />Attorriey and acknowledged said instrument to be her voluntary act and deed. <br />WITNESS my Hand and Seal the day and <br />ney <br />� � � of 2 <br />