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201801817 <br />GRANT OF SPECIFIC AUTHORITY (OPTIONAL) <br />My agent MAY NOT do any of the following specific acts for me UNLESS I have INITIALED <br />the specific authority listed below: <br />(CAUTION: Granting any of the following will give your agent the authority to take actions that could <br />significantly reduce your property or change how your property is distributed at your death. INITIAL <br />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 />( <br />( <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 <br />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 />LIMITATION ON AGENTS AUTHORITY <br />Except as otherwise authorized by the Power of Personal and Family Maintenance, an agent <br />MAY 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 />SPECIAL INSTRUCTIONS (OPTIONAL) <br />You may give special instructions on the following lines: <br />This power of attorney revokes all prior powers of attorney executed by me. <br />EFFECTIVE DATE <br />This power of attomey is effective immediately unless I have stated otherwise in the Special <br />Instructions. <br />Page 3 <br />