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( ) Waive the principal's right to be a beneficiary of a joint or survivor <br />annuity, including a survivor benefit under a retirement plan <br />( <br />Exercise fiduciary powers that the principal has authority to delegate <br />( ) Renounce or disclaim an interest in property, including a power of <br />appointment <br />The agent is not to receive compensation. <br />EFFECTIVE DATE: February 5, 2014. <br />This Power of Attorney is effective immediately unless I have stated otherwise <br />in the Special Instructions. <br />NOMINATION OF [CONSERVATOR OR GUARDIAN] (OPTIONAL). <br />If it becomes necessary for a court to appoint a conservator or guardian of my <br />estate or guardian of my person, I nominate the following person for <br />appointment: <br />Name of Nominee for <br />conservator or guardian of <br />my estate: <br />Nominee's Address: <br />Nominee's Telephone Number: <br />RELIANCE ON THIS POWER OF ATTORNEY: <br />Larry Kuta <br />4069 Horseshoe Place <br />Grand Island, NE 68803 <br />308 - 384 -3362 <br />0i500i0G <br />Any person, including my agent, may rely upon the validity of this Power of <br />Attorney or a copy of it unless that person knows it has terminated or is <br />invalid. <br />