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NEBRASKA STATUTORY FORM POWER OF ATTORNEY IMPORTANT INFORMATION This power of attorney authorizes another person (your agent) to make decisions concerning your property for you (the principal). Your agent will be able to make decisions and act with respect to your property (including your money) whether or not you are able to act for yourself. The meaning of authority over subjects listed on this form is explained In the Nebraska Uniform Power of Attorney Act. This power of attorney does not authorize the agent to make health care decisions for you. You should select someone you trust to serve as your agent. Unless you Specify otherwise, generally the agent's authority will continue until you die or revoke the power of attorney or the agent tresigns or i$ unable to act for you. This form will not revoke a power of attorney previously executed by yot unless you add that the previous power of attorney is revoked or that all other powers of attorney are revoked by this power of attorney. Your age 4t is entitled to-reasonable compensation unless you statefotherwlse in the Special instructions. This foam provides for designation of one agent. If you wish to name more than one agent you may name a coagent in the Special Instructions. Coagents are not required to act together unless you include that requirement in the Special instructions. If your agent is unable or unwilling to act for you, your power of attorney will end unless you have named a successor agent. You may also name a second successor agent. This power of attorney becomes effective immediately unless you state otherwise in the Special Instructions. If you have questions about the power of attorney or the authority you are granting to your agent, you should seek legal advice before signing this form. DESIGNATION OF AGENT L3 R - ?- o (r . (name of principal) lame the following person as my agent: Name of Agent: 3a rgt1P,1 . trlh Agent's Address: S 6.0,..5 4- z-c> ' Agent's Telephone Number: . - :3rd' =' 3 DESIGNATION OF SUCCESSOR AGENT(S) (OPTIONAL) If my agent is unable or unwilling to. act for me, 1 name as my successor agent: Name of Second Successor Agent: S econd Successor Agent's Addss. :Srico "Sticce`saor- Agents iephone•Number: mg to act for me, I name as my second successor agent: Release of information l agree to, suthQr e•e • And- a llow :full release of information, by any govennmerrtai agency, business& editor or third a who'ma have i nformad"an ertalnlri to P rtY� Y p S mY assets or incxirree, #o iriy°agept na cr m ed:h erein. Name of Successor Agent: f? 15a Successor Agent's Address: 20/404287 C w ie Successor Agent's Telephone Number. ' If usable "or u rtwI