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201808171 <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 />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 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 AGENT'S AUTHORITY <br />Except as otherwise authorized by the Power of Personal and Family Maintenance, an <br />agent MAY NOT use my property to benefit the agent or a person to whom the agent owes an <br />obligation of support unless I have included that authority in the Special Instructions or the Grant <br />of Specific Authority. <br />SPECIAL INSTRUCTIONS <br />You may give special instructions on the following lines: <br />EFFECTIVE DATE <br />This Power of Attorney is effective immediately unless I have stated otherwise in the <br />Special Instructions. <br />NOMINATION OF CONSERVATOR OR GUARDIAN <br />If it becomes necessary for a court to appoint a Conservator of my estate or Guardian of <br />my person, I nominate the following person(s) for appointment: <br />Name of Nominee for Conservator of my estate/ <br />Guardian of my person: SAMANTHA R. LOMASNEY <br />Nominee's Address: 4318 Indian Grass Circle <br />Grand Island, Nebraska 68803 <br />Nominee's Telephone Number: (308) 380-0625 <br />NOMINATION OF SUCCESSOR CONSERVATOR OR GUARDIAN <br />If my nominated Conservator or Guardian is unable or unwilling to serve, I nominate the <br />following person for appointment as Successor Conservator of my estate or Successor Guardian <br />of my person: <br />3 of 6 <br />