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rn <br />N <br />_. c <br />.�� n z <br />c r . . <br />co .�� <br />Record And Return to: <br />Grand Island Abstract, Escrow and Title Co. <br />704 W. Third Street, Grand Island, NE 68801 <br />(4)Other relevant statements, if any , are as follows: <br />Dated: R' , 2016. <br />Agent's Name: Gerald Lee Kohtz �// <br />Agent's Address: ga'2_ 3-e_ I� <br />Agent's Phone: <br />6'B16AM NOTlMII- Stet ofNebula <br />KELLY S. FITOHHORN <br />My Comm. Exp. February 14, 2018 <br />(seal) <br />Gerald Lee Kohtz <br />G ^� <br />ry <br />0) <br />w) <br />C, <br />-a <br />m <br />AGENT'S CERTIFICATION AS TO THE VALIDITY OF POWER OF ATTORNEY <br />AND AGENT'S AUTHORITY <br />I, Gerald Lee Kohtz, certify under penalty of perjury that Mildred I. Kohtz, Principal, granted me <br />authority as an agent or successor agent in a power of attorney dated August 24, 1994 which is <br />attached hereto. <br />• <br />I further certify that to my knowledge: <br />The Principal is alive and has not revoked the Power of Attorney and my authority to act under the <br />Power of Attorney and the Power of Attorney has not terminated; <br />(1)If the power of Attorney was drafted to become effective upon the happening of an event or <br />contingency, the event or contingency has occurred; <br />(2)If I was named as a successor agent, the prior agent(s) is /are no longer able or willing to <br />serve; <br />(3)The Agent is conveying Principal's interest in the following described real estate: <br />Lot Twenty -Two (22), Block One (1), Island Acres Number 2, a Replat of Lots <br />1,2,3,5,6 & 7 Island Acres, in the City of Grand Island, Hall County, Nebraska. <br />STATE OF A /eh ta "4_ <br />COUNTY OF 2 !. / <br />The foregoing instrument was acknowledged before me on ,21 , 2016 <br />by Gerald Lee Kohtz. <br />