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201906985 <br />Nominee's Address: <br />Nominee's Telephone Number: <br />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 />Any person, including my agent, may rely upon the validity of this power of attorney or a copy <br />of it unless that person knows it has terminated or is invalid. <br />Dale D. Johnson <br />1022 N. Custer, Grand Island, NE 68803 <br />(308) 384-8610 <br />SIGNATURE AND ACKNOWLEDGMENT <br />Date <br />STATE OF NEBRASKA ) <br />) ss. <br />COUNTY OF HALL ) <br />This document was acknowledged before me on this 6 day of <br />Dale D Johnson. <br />NO A Y 14L114111C <br />,2018 by <br />GENERAL NOTARY - State of Nebraska <br />KEVIN A. BROSTROM <br />7 My Comm. Exp. September 25, 2018 <br />