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Durable Power of Attorney <br />NOTICE: THE POWERS GRANTED BY THIS DOCUMENT ARE BROAD AND SWEEPING. IF YOU HAVE <br />ANY QUESTIONS ABOUT THESE POWERS, OBTAIN COMPETENT LEGAL ADVICE. THIS DOCUMENT <br />DOES NOT AUTHORIZE ANYONE TO MAKE MEDICAL AND OTHER HEALTH -CARE DECISIONS FOR <br />YOU. YOU MAY REVOKE THIS DURABLE POWER OF ATTORNEY IF YOU LATER WISH TO DO SO. <br />Definition of Agent <br />As used in this document, the term "Agent" shall include all agent(s), attorney(s) -in -fact, attorneys -in- <br />fact / agents, and mandatary or mandataries who are appointed herein. <br />TO ALL PERSONS, be it known, that I, V.:I NIA') f afi , the undersigned <br />l(; h o (e- pi_ <br />, County of - og 4-1\[ 4-P <br />, do hereby appoint p4. r H t.) ;Ng. t.r fC .1 as my <br />as my Agent, who Wmust act jointly ❑ may act <br />Principal, who resides at <br />City of <br />State of 1 L 014,44 <br />Agent, and <br />separately on my behalf. <br />201801500 <br />At the time of the execution of this Durable Power of Attorney, <br />A N E i ' / /14 E{ /UA v o f resides at 3 9 0 7 7 (f r h r , 1'C'- <br />City of c - d1 - q , County of t RjJ /1/4i 4 e. <br />At the time of the execution of this Durable Power of Attorney, <br />N/4 resides at <br />City of , County of , State of <br />• <br />If one of my Agents is unable to serve for any reason, ❑ I authorize the remaining named Agent to <br />act as my sole Agent OR ❑ I designate , residing at <br />, County of <br />, State of <br />City of <br />N <br />, State of <br />/V' , t serve in that person's place. <br />If both of my Agents are unable to serve for any reason, I designate <br />, residing at <br />City of , County of , State of <br />, as my Successor Agent. <br />©SmartLegatForms LF205 Durable Power of Attorney 6 -15, Pg. 1 of 7 <br />