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201502830 <br />Waive the principal's right to be a beneficiary of a joint and survivor annuity, including a <br />survivor benefit under a retirement plan <br />Exercise fiduciary powers that the principal has authority to delegate <br />Renounce or disclaim an interest in property, including a power of appointment <br />LIMITATION ON AGENT'S AUTHORITY <br />Except as otherwise authorized by the Power of Personal and Family Maintenance, an <br />agent MAY NOT use my property to benefit the agent or a person to whom the agent owes an <br />obligation of support unless I have included that authority in the Special Instructions or the Grant <br />of Specific Authority. <br />SPECIAL INSTRUCTIONS <br />You may give special instructions on the following lines: <br />Coagents are as provided hereinabove. <br />EFFECTIVE DATE <br />This Power of Attorney is effective immediately unless I have stated otherwise in the <br />Special Instructions. <br />NOMINATION OF CONSERVATOR OR GUARDIAN <br />If it becomes necessary for a court to appoint a conservator of my estate or guardian of <br />my person, I nominate the following person(s) for appointment: <br />Name of Nominee for conservator of my estate/ <br />guardian of my person: SALLY ANN ANDERSON <br />Nominee's Address: 1451 West Laurenwood Way <br />Littleton, Colorado 80129 <br />Nominee's Telephone Number: (303) 981 -4959 <br />NOMINATION OF SUCCESSOR CONSERVATOR OR GUARDIAN <br />If my nominated conservator or guardian is unable or unwilling to serve, I nominate the <br />following person for appointment as successor conservator of my estate or successor guardian of <br />my person: <br />Name of Nominee for successor conservator of my estate/ <br />guardian of my person: DONNA KANTER KUNZE <br />Successor Nominee's Address: 183 3r Avenue <br />St. Libory, Nebraska 68872 <br />Successor Nominee's Telephone Number: (308) 687 -6145 <br />3 of 6 <br />