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Name of Nominee for (guardian) of my person: <br />Nominee's Address: <br />Nominee's Telephone Number <br />RELIANCE ON THIS POWER OF ATTORNEY <br />201901'830 <br />Sandra M. Krolikowski <br />4706 N. Cameron Road <br />Cairo, NE 68824 <br />3o -3 '(;'rs. <br />Any person, including my agent, may rely upon the validity of this power of attorney or a <br />copy of it unless that person knows it has terminated or is invalid. <br />SIGNATURE AND ACKNOWLEDGMENT <br />I <br />41)m*i R ,)614,-tiAr <br />Signature <br />Printed Name Norman R. Krolikowski <br />Address 4706 N. Cameron Road <br />Cairo, NE 68824 <br />b 10 c'a b,/ <br />Telephone Number <br />STATE OF NEBRASKA <br />COUNTY OF HALL <br />This document was acknowledged before me on <br />Norman R. Krolikowski. <br />SS: <br />Notary Public <br />My commission expires: <br />Date <br />(;(' ////4, <br />(e'M <br />(Seal, if any) <br />GENERAL NOTARY - State of Neb asks <br />JOHN B. MCDERMOTT <br />M Comm. Exp. March 22, 20111 <br />This document prepared by: <br />John B. McDermott <br />SHAMBERG, WOLF, McDERMOTT & DEPUE <br />308 N. Locust St., Suite 501 <br />PO Box 460 <br />Grand Island, NE 68802 <br />(308) 384-1635 <br />f if'1(oby <br />Page 3 of 3 <br />