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! y p a s Q _ . � ° k. 20120533� 20110093� physical or mental health including medical and hospital records and to execute any releases or other documents that may be required in order to obtain such information; to make health care decisions on my behalf including choice of care and therapy, the selection of physicians, hospitals, and health care facilities; to sign the necessary consents, releases, claims, insurance forms, and waivers; and to make any and all decisions regarding the commencement or withdrawal of life support measures; i) To make application for benefits or assistance through the Nebraska Department of Health and Human Services or any other service; j) Giving and granting unto the said attorney-in-fact full power and authority to do and perForm every act and thing whatsoever requisite and necessary to be done in and about the premises, as fully to all extent and purposes as I might or could do if personally present, rafify and confirming all that said attomey-in-fact shall lawFully do or cause to be done by virtue of these presents. This power of attomey shall not be affected by disability of the undersigned principal, and all acts done by the said attomey in fact hereunder shall have the same effect and inure to the benefit of and bind myself, my heirs, devisees and personal representatives. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 27th day of Nove er, 2007. f� Richard E. Davis STATE OF NEBRASKA COUNTY OF HALL ) ) :ss ) BE IT REMEMBERED that on the 27th day of November, 2007, before me the undersigned, a Notary Public in and for said State, personally appeared Richard E. Davis, to me known to be the identical person described in and who executed the foregoing Power of Attorr�ey and acknowledged said instrument to be his �roluntary act and deed. WITNESS my Hand and Seal the day and y�'a� last �jEADAA E �V 1 9� � written. Richard E. Davis, Power of Attomey Page 2 of 2