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201802328 Insurance and Annuities Estates, Trusts, and Other Beneficial Interests Claims and Litigation Personal and Family Maintenance Benefits from Governmental Programs or Civil or Military Services Retirement Plans �.� Taxes l(; All Preceding Subjects GRANT OF SPECIFIC AUTHORITY (OPTIONAL) My agent MAY NOT do any of the following specific acts for me UNLESS I have INITIALED the specific authority listed below: (CAUTION: Granting any of the following will give your agent the authority to take actions that could significantly reduce your property or change how your property is distributed at your death. INITIAL ONLY the specific authority you WANT to give your agent.) Create, amend, revoke, or terminate an inter vivos trust Make a gift, subject to the limitations of the Nebraska Uniform Power of Attorney Act and any special instructions in this power of attorney Create or change rights of survivorship Create or change a beneficiary designation Delegate to another person to exercise the authority granted under this power of attorney Waive the principal's right to be a beneficiary of a joint and survivor annuity, including a survivor benefit under a retirement plan Exercise fiduciary powers that the principal has authority to delegate Renounce or disclaim an interest in property, including a power of appoinhrnent LIMITATION ON AGENT'S AUTHORITY Except as otherwise authorized by the Power of Personal and Family Maintenance, an agent MAY NOT use my property to benefit the agent or a person to whom the agent owes an obligation of .support unless I have included that authority in the Special Instructions or the Grant of Specific Authority. SPECIAL INSTRUCTIONS: F, / This power of attorney is effective immediately. This Power of Attorney is effective only in the event of my mental incapacity and inability to make my financial decisions as confirmed by my treating physician. Page 2 3