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RELEASE OF INFORMATION <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 nay agent and any successor agent general authority to act for me with respect to <br />the 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 />0 4. All Preceding Subjects <br />GRANT OF SPECIFIC AUTHORITY <br />201707983 <br />My agent MAY NOT do any of the following specific acts for me UNLESS I have <br />INITIALED 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 Uniform Power of Attorney Act <br />and any special instructions in this Power of 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 power of appointment <br />2 of 5 <br />