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SPECIAL INSTRUCTIONS <br />You may give special instructions on the following lines: <br />All other previous Durable Powers of Attorney are hereby revoked. <br />This power of attorney is effective immediately unless I have stated otherwise in <br />the Special Instructions. <br />If it becomes necessary for a court to appoint a conservator of my estate and /or <br />guardian of my person, I nominate the following person(s) for appointment: <br />Name of Nominee for conservator and /or guardian: Jane Ambroz <br />Nominee's Address: 2719 W. 24th Street #15, Kearney, NE 68845 <br />Nominee's Telephone Number: 308 - 224 -0591 <br />Any person, including my agent, may rely upon the validity of this power of <br />attorney or a copy of it unless that person knows it has terminated or is invalid. <br />Ju f - Ambroz <br />2724 W. 5 Street <br />Grand Island, NE 68803 <br />308 - 382 -6772 <br />NOMINATION OF CONSERVATOR AND /OR GUARDIAN <br />STATE OF NEBRASKA ) <br />) ss: <br />COUNTY OF HALL <br />My commission expires: <br />l A GENBRAL Staoe I <br />11I.IC a OI IOMO <br />EFFECTIVE DATE <br />RELIANCE ON THIS POWER OF ATTORNEY <br />SIGNATURE AND ACKNOWLEDGMENT <br />(Date) <br />This document was acknowledged before me on this 4 day of October, 2016, by <br />Julie Ambroz. <br />/12-10,4‹ <br />Notary Public <br />This document prepared by: <br />201G07620 <br />