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GRANT OF SPECIFIC AUTHORITY (OPTIONAL) <br />My agent MAY NOT do any of the following specific acts for me UNLESS I have INITIALED the <br />specific authority listed below: <br />This power of attorney is effective immediately unless I have stated otherwise in the Special <br />Instructions. <br />SPECIAL INSTRUCTIONS (OPTIONAL) <br />You may give special instructions on the following lines: <br />EFFECTIVE DATE <br />201801667 <br />(CAUTION: Granting any of the following will give your agent the autho to take actions that <br />could significantly reduce your property or change how your proper • istributed at your death. <br />INITIAL ONLY the specific authority you WANT to give yo •e t.) <br />) Create, amend, revoke, or terminate an int vos trust <br />( ) Make a gift, subject to the limitations e Uniform Power of Authority Act [insert citation <br />to Section 217 of the act] and any speci nstructions in this power of attorney <br />) Create or change rights of . i vorship <br />) Create or change a Clary designation <br />) Delegate to an* - person to exercise the authority granted under this power of attorney <br />) Waive • ncipal's right to be a beneficiary of a joint and survivor annuity, including a <br />survivor b t under a retirement plan <br />xercise fiduciary powers that the principal has authority to delegate <br />Renounce or disclaim an interest in property, including a power of appointment <br />LIMITATION ON AGENT'S AUTHORITY <br />Except as otherwise authorized by the Power of Personal and Family Maintenance, an agent MAY <br />NOT use my property to benefit the agent or a person to whom the agent owes an obligation of <br />support unless I have included that authority in the Special Instructions or the Grant of Specific <br />Authority. <br />