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201801817 <br />NEBRASKA STATUTORY FORM POWER OF ATTORNEY <br />IMPORTANT INFORMATION <br />This power of attorney authorizes another person (your agent) to make decisions concerning <br />your property for you (the principal). Your agent will be able to make decisions and act with respect <br />to your property (including your money) whether or not you are able to act for yourself. The meaning <br />of authority over subjects listed on this form is explained in the Nebraska Uniform Power of Attorney <br />Act. <br />This power of attorney does not authorize the agent to make health care decisions for you. <br />You should select someone you trust to serve as your agent. Unless you specify otherwise, <br />generally the agent's authority will continue until you die or revoke the power of attorney or the agent <br />resigns or is unable to act for you. <br />This form will not revoke a power of attomey previously executed by you unless you add that <br />the previous power of attorney is revoked or that all other powers of attorney are revoked by this <br />power of attorney. <br />Your agent is entitled to reasonable compensation unless you state otherwise in the Special <br />instructions. <br />This form provides for designation of one agent. If you wish to name more than one agent <br />you may name a coagent in the Special Instructions. Coagents are not required to act together <br />unless you include that requirement in the Special Instructions. <br />If your agent is unable or unwilling to act for you, your power of attorney will end unless you <br />have named a successor agent. You may also name a second successor agent. <br />This power of attorney becomes effective immediately unless you state otherwise in the <br />Special Instructions. <br />If you have questions about the power of attorney or the authority you are granting to your <br />agent, you should seek legal advice before signing this form. <br />p DESIGNATION OF AGENT <br />I ,n04/44 •• :•.RM dV (name of principal) name the following person as my agent: <br />Name of Agent: 4i4 1... <br />Agent's Address: ? , - Q4 7� ,YtO' 71 zmlca[,.,0 , �. <br />Agent's Telephone Number: h�O �f & ?--- 6 lO <br />DESIGNATION OF SUCCESSOR AGENT(S) (OPTIONAL) <br />If my agent is unable or unwilling to act for me, 1 name as my successor agent: <br />Name of Successor Agent: .1.44' . Zi i72 54 i <br />Successor Agent's Address: h 72. AQ.../ , /i!11cez•-N, <br />Successor Agent's Telephone Number: Z V.S. -- a ..) 5 <br />6a3' <br />Pagel <br />