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202001896
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Last modified
3/26/2020 3:38:55 PM
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3/26/2020 3:38:54 PM
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202001896
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NEBRASKA STATUTORY FORM POWER OF ATTORNEY <br />JULIO LOPEZ <br />IMPORTANT INFORMATION <br />coa&-tg v <br />202001EA6 <br />( 0 <br />y <br />• This power of attorney authorizes another person (your agent) to make decisions concerning your property for you <br />(the principal). Your agent will be able to make decisions and act with respect to your property (including your <br />money) whether or not you are able to act for yourself. The meaning of authority over subjects listed on this form is <br />explained in the Nebraska Uniform Power of Attorney Act, <br />• This power of attorney does not authorize the agent to make health care decisions for you. <br />• You should select someone you trust to serve as your agent. Unless you specify otherwise, generally the agent's <br />authority will continue until you die or revoke the power of attorney or the agent resigns or is unable to act for you, <br />• This form will not revoke a power of attorney previously executed by you unless you add that the previous power of <br />attorney is revoked or that all other powers of attorney are revoked by this power of attorney. <br />• Your agent is entitled to reasonable compensation unless you state otherwise in the Special Instructions. <br />• This form provides for designation of one agent. If you wish to name more than one agent you may name a co - <br />agent in the Special Instructions. Co -agents are not required to act together unless you include that requirement in <br />the Special Instructions. <br />• If your agent is unable or unwilling to act for you, your power of attorney will end unless you have named a <br />successor agent. You may also name a second successor agent. <br />• If you have questions about the power of attorney or the authority you are granting to your agent, you should seek <br />legal advice before signing this form. <br />DESIGNATION OF AGENT: I, Julio Lopez, name the following person as my agent: Quelin Norali Hemandez Gonzales, <br />2121 W. 14th Street, Grand Island, Nebraska 68803 (308) 383-8246. <br />DESIGNATION OF SUCCESSOR AGENT: If my agent is unable or unwilling to act for me, I name as my successor agent: <br />N/A , Nebraska ( ) - <br />RELEASE OF INFORMATION: I agree to, authorize, and allow full release of information, by any governmental agency, <br />business, creditor, or third party who may have information pertaining to my assets or income, to my agent named herein. <br />GRANT OF GENERAL AUTHORITY: I grant my agent and any successor agent durable general authority to act for me <br />with respect to the following subjects as defined in the Nebraska Uniform Power of Attomey Act: (INITIAL each subject you <br />want to include in the agent's general authority. If you wish to grant general authority over all of the subjects you may <br />Initial "All Preceding Subjects" instead of Initialing each subject.) <br />( ) Real Property <br />( ) Tangible Personal Property <br />( ) Stocks and Bonds <br />( ) Commodities and Options <br />( ) Banks and Other Financial Institutions <br />( ) Operation of Entity or Business <br />(_ ) Insurance and Annuities <br />(7=L-) All Preceding Subjects <br />( ) Estates, Trusts, and Other Beneficial Interests <br />( ) Claims and Litigation <br />( ) Personal and Family Maintenance <br />( ) Benefits from Governmental Programs or Civil or <br />Military Service <br />( ) Retirement Plans <br />( ) Taxes <br />MAYER BURNS & KOENIG, 308 N. Locust Street, Suite 306, Grand island, NE 68801-5984 <br />Page 1 <br />
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