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201707117 <br />I agree to, authorize, and allow full release of information, by any governmental agency, <br />business, creditor, or third party who may have information pertaining to my assets or income, to <br />my agent named herein. <br />GRANT OF GENERAL AUTHORITY <br />I grant my agent and any successor agent general authority to act for me with respect to the <br />following subjects as defined in the Nebraska Uniform Power of Attorney Act: <br />(INITIAL each subject you want to include in the agent's general authority. If you wish to grant <br />general authority over all of the subjects you may initial "All Preceding Subjects" instead of <br />initialing each subject.) <br />( ) Real Property <br />( ) Tangible Personal Property <br />( ) Stocks and Bonds <br />( ) Commodities and Options <br />( ) Banks and Other Financial Institutions <br />( ) Operation of Entity or Business <br />( ) Insurance and Annuities <br />( ) Estates, Trusts, and Other Beneficial Interests <br />( ) Claims and Litigation <br />( ) Personal and Family Maintenance <br />( ) Benefits from Governmental Programs or Civil or Military Service <br />( ) Retirement Plans <br />( ) Taxes <br />All Preceding Subjects <br />GRANT OF SPECIFIC AUTHORITY (OPTIONAL) <br />My agent MAY NOT do any of the following specific acts for me UNLESS I have INITIALED <br />the specific authority listed below: <br />(CAUTION: Granting any of the following will give your agent the authority to take actions that <br />could significantly reduce your property or change how your property is distributed at your <br />death. INITIAL ONLY the specific authority you WANT to give your agent.) <br />( ) Create, amend, revoke, or terminate an inter vivos trust <br />( ) Make a gift, subject to the limitations of the Nebraska <br />Uniform Power of Attorney Act and any special instructions in this power of <br />attorney <br />( ) Create or change rights of survivorship <br />( ) Create or change a beneficiary designation <br />( ) Delegate to another person to exercise the authority granted under this power of attorney <br />( ) Waive the principal's right to be a beneficiary of a joint and survivor annuity, including a <br />survivor benefit under a retirement plan <br />( ) Exercise fiduciary powers that the principal has authority to delegate <br />( ) Renounce or disclaim an interest in property, including a <br />power of appointment <br />