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201704501 <br />request for information by my agent as the request of my personal representative and to honor such <br />requests as if they were my own. I hereby waive all privileges which may be applicable to such <br />information and records and to any communication pertaining to me and made in the course of any <br />confidential relationship recognized by law. My agent may also disclose such information to such <br />persons as my agent shall deem appropriate. I understand that any information redisclosed by my <br />agent is no longer protected by federal privacy regulations covering health care providers. <br />Furthermore, I understand that this authorization for release of medical information may be revoked <br />in writing at any time, except to the extent that the health care provider has taken action in reliance <br />on the authorization. This authorization for release of medical information shall expire upon the <br />earlier event of my naming of a new agent or my death. This authorization and request shall also be <br />considered a consent to the release of such information under current laws, rules and regulations as <br />well as under future laws, rules and regulations and amendments to such laws, rules and regulations <br />to include but not be limited to the express grant of authority to personal representatives as provided <br />by Regulation Section 164.502(g) of Title 45 of the Code of Federal Regulations and the medical <br />information privacy law and regulations generally referred to as HIPAA. <br />21. To Exercise Certain Rights to Property. To exercise any right I may have to <br />renounce or disclaim any interest in property; to exercise my right to claim an elective share of the <br />estate of a spouse, or claim a homestead or exempt property allowance. <br />22. To Exercise Rights Relating to Insurance and Other Benefit Plans. To exercise <br />any right to elect benefit or payment options, to terminate, to change beneficiaries or ownership, to <br />assign rights, to borrow or receive cash value in return for the surrender of any or all rights under any <br />1,,,of.the following: (a) Life insurance ar,d annuity policies, plans or benefits: (b) Mutual funds and <br />other dividend investment plans; and (c) Retirement, profit sharing and employee welfare plans and <br />benefits. <br />23. To Redirect Mail. To redirect my mail and to execute and deliver all documents <br />associated therewith; to enter any mail box which I shall have hired, whether at a United States Post <br />Office or elsewhere, and to surrender the box and terminate the lease at his or her discretion; to sign <br />for any certified or registered mail directed to me, and to execute any order required to forward mail <br />to any location selected by my agent. <br />24. To Deal with Credit Cards, Memberships, Associations, etc. To cancel or <br />continue any of my credit cards, charge accounts, and memberships in clubs or associations. <br />25. To Take Custody of Documents. To take custody of my Will, trust agreements, <br />deeds, life insurance policies, contracts, securities and other important documents. <br />26. To Engage or Dismiss Servants. To engage, employ, compensate, and dismiss any <br />agents, clerks, servants, attorneys at law, accountants, investment advisors, custodians, or other <br />persons providing services which, in the opinion ofmy agent, should be performed or dispensed with <br />in furtherance of my interests or my estate; and to pay for any or all such services performed out of <br />my assets. This authority shall include employment of partnerships, firms, and companies in which <br />my agent owns equity interests or in which my agent is otherwise pecuniarily interested. <br />5 <br />