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201505615
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Last modified
11/5/2015 9:11:33 PM
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8/17/2015 4:15:28 PM
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DEEDS
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201505615
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otherwise to act as my attorney or proxy, with power of substitution, in respect of any stocks, shares, <br />bonds, debentures, or other evidence of ownership, or securities, now or hereafter held by me and <br />issued by or on account of said corporation or company and for that purpose to execute any proxies, <br />limited or general, or other instruments. <br />11. To execute deeds. bills, notes, and similar instruments. For all or any of the <br />purposes herein stated to enter into and sign, seal, execute, acknowledge, and deliver any contracts, <br />deeds, or other instruments whatsoever, and to draw, accept, make, endorse, discount, or otherwise <br />deal with any bills of exchange, checks, promissory notes, or other commercial or mercantile <br />instruments. <br />12. Health Care Decisions. Provisions & Limitations. <br />(a) General statement of authority granted. If I no longer have the capacity to <br />make health care decisions for myself, I hereby grant to my true lawful attorney (hereinafter <br />agent) full power and authority to make health care decisions for me to the same extent that I <br />could make such decisions for myself if I had the capacity to do so. My incapacity to make <br />health care decisions for myself shall be certified in writing by my treating physician and <br />confirmed by a second physician who has personally examined me. In exercising this <br />authority, I request my agent to make health care decisions that are consistent with my desires <br />as stated in this document or which I have otherwise made known to my agent. My agent <br />may also make health care decisions about which 1 have not stated my desires. <br />(b) Inspection and disclosure of information relating to my physical or mental <br />health; signing documents, consents and releases. My agent has the power and authority <br />to: (1) obtain medical and health care records and any other information regarding my <br />physical or mental health; (2) execute on my behalf any releases or other documents that <br />may be required in order to obtain such information; (3) consent to the disclosure of such <br />information to others; (4) execute any document necessary to implement the health care <br />decisions made by my agent; and (5) execute any waiver or release from liability that my <br />agent determines to be appropriate. <br />13. To do all other things necessary in connection herewith. In general to do all other <br />acts, deeds matters, and things whatsoever in or about my estate, property and affairs, or to concur <br />with persons jointly interested with myself therein in doing all acts, deeds, matters, and things herein, <br />either particularly or generally described, as fully and effectually to all intents and purposes as I <br />could do in my own proper person if personally present, it being my intent to grant to my said <br />attorney a general power to act for me and in my behalf, and not a limited or special power, limited <br />to the specific acts herein described. <br />Power of attorney effective notwithstanding disability of principal; continues in effect after <br />principal's death until notice. Pursuant to the provisions of Nebraska Uniform Durable Power of <br />Attorney Act, I declare that this power of attorney shall not be affected by my disability or incapacity, <br />3 <br />201505615 <br />H0031331 - F022611032 - LOY, BERNICE R - • PRINTED BY: Lora A Mouse! <br />Advance Directive - Page 5/12 Job 10742 (06/26/2014 07:21) - Page 5 Doc# 1 <br />
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