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201901780
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Last modified
3/28/2019 4:19:09 PM
Creation date
3/28/2019 3:57:09 PM
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DEEDS
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201901780
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201001780 <br />(CAUTION: Granting any of the following will give your agent the authority to take <br />actions that could significantly reduce your property or change how your property is distributed <br />at your death. INITIAL 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 <br />Act 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 <br />attorney <br />Waive the principal's right to be a beneficiary of a joint and survivor annuity, <br />including a 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 />This power of attorney is effective immediately. <br />This Power of Attorney is effective only in the event of my mental incapacity <br />and inability to make my financial decisions as confirmed by my treating <br />physician. <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) (OPTIONAL) <br />If it becomes necessary for a court to appoint a (conservator or guardian) of my estate or <br />(guardian) of my person, I nominate the following person(s) for appointment: <br />Name of Nominee for (conservator or guardian) of my estate: Sandra M. Krolikowski <br />Nominee's Address: <br />Nominee's Telephone Number: <br />4706 N. Cameron Road <br />Cairo, NE 68824 <br />30g 383 q)/5 <br />Page 2 of 3 <br />
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