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NOMINATION OF CONSERVATOR OR GUARDIAN (OPTIONAL) <br />If it becomes necessary for a court to appoint a conservator of my estate or guardian of my <br />person, I nominate the following person(s) for appointment: <br />Name of nominee for conservator of my estate: <br />Nominee's address: <br />201602712 <br />Nominee's telephone number: <br />Name of nominee for guardian of my person: <br />Nominee's address: <br />Nominee's telephone number: <br />RELIANCE ON THIS POWER OF ATTORNEY <br />Any person, including my agent, may rely upon the validity of this power of attomey or a <br />copy of it unless that person knows it has terminated or is invalid. <br />Your signature <br />Brenda Joyce Bartu <br />Your name printed <br />221 Rockview Dr. <br />Superior, CO 80027 <br />Your address <br />720- 425 -9220 <br />Your telephone number <br />SIGNATURE AND ACKNOWLEDGMENT <br />Date <br />STATE OF COLORADO STATUTORY FORM POWER OF ATTORNEY Page 4 of 6 <br />