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agent: <br />If my successor agent is unable or unwilling to act for me, 1 name as my second successor <br />Name of Second Successor Agent: <br />Second Successor Agent's Address: <br />Second Successor Agent's Telephone Number: <br />Release of Information <br />1 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 my <br />agent named herein. <br />GRANT OF GENERAL. AUTHORITY <br />I grant my agent and any successor agent general authority to act for me <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 <br />general authority over all of the subjects you may initial "All Preceding Subjects" <br />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 />II Preceding Subjects <br />Page 2 <br />201801817 <br />73� <br />2- C14 U Ho LLD +4.J <br />74, �• S 7S 0 <br />`ill 2 V29— 3 0 ... <br />with respect to the <br />you wish to grant <br />instead of initialing <br />