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200106733
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Last modified
10/14/2011 6:46:07 AM
Creation date
10/20/2005 9:20:56 PM
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DEEDS
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200106733
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200106'733 <br />STATE OF NEBRASKA ) <br />SS. <br />County of Hall ) <br />On this 4c day of July, 1997, before me, a Notary Public in <br />and for Hall County, Nebraska, personally came Mary Jean <br />Drawbaugh, to me known to be the identical person whose name is <br />affixed to the above Power of Attorney for Health Care as <br />principal, and I declare that she appears in sound mind and not <br />under duress or undue influence; that she acknowledges the <br />execution of the same to be her voluntary act and deed, and that I <br />am not the attorney -in -fact or successor attorney -in -fact <br />designated by the Power of Attorney for Health Care. <br />WITNESS my hand and notarial seal at Grand Island, Nebraska, <br />in such County the day and year last above written. <br />Prot d NI DIXIE <br />Comm WW. ATI: NOTARY PUBLIC' <br />DECLARATION OF WITNESSES <br />We declare that the principal is personally known to me; that <br />the principal signed or acknowledged her signature on this Durable <br />Power of Attorney, including the Power of Attorney for Health Care <br />in our presence; that the principal appears to be of sound mind <br />and not under duress or undue influence; and that neither of, nor <br />the principal's attending physician is the person appointed as <br />attorney -in -fact by this document. <br />WITNESSED tY: <br />( I NATURE OF WITNESS /D E) <br />(SIGNATURE OF ITNESS /DATE) <br />(PRINTED NAME OF WITNESS) <br />(PRINTED NAME OF WIT ESS) <br />
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