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THIS POWER OF ATTORNEY FOR HEALTH CARE THAT THE FACT OF MY <br />INCAPACITY IN THE FUTURE BE CONFIRMED BY A SECOND PHYSICIAN. <br />DATED: June 2006 <br />201606213 <br />DECLARATION OF WITNESSES <br />We declare that the principal is personally known to me; that the principal signed <br />or acknowledged his signature on this Durable Power of Attorney and Power of Attorney <br />for Health Care in our presence; that the principal appears to be of sound mind and not <br />under duress or undue influence; and that neither of, nor the principal's attending <br />physician, is the person appointe4l as attorney -in -fact by this document. <br />JAMES A. WAGONER <br />(Printed Name of Witness) <br />THOMAS A. WAGONER <br />(Printed Name of Witness) <br />