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200009039
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Last modified
10/13/2011 8:57:01 PM
Creation date
10/20/2005 9:59:12 PM
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DEEDS
Inst Number
200009039
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200009039 <br />4. Interpretation and Governing Law. This instrument is to <br />be construed and interpreted as a General Durable Power of Attorney <br />and Durable Power of Attorney for Health Care. This instrument is <br />executed and delivered in the State of Nebraska, and the laws of <br />said State shall govern all questions as to the validity of this <br />Power of Attorney and the construction of its terms and provisions. <br />7. Disability of Principal. This Durable General and Health <br />Care Power of Attorney shall not be affected by my disability and <br />shall remain in full force and effect throughout any period of <br />disability. <br />IN WITNESS WHEREOF, I have executed this document this 16th <br />day of August, 1995, at Grand Island, Hall County, Nebraska. <br />I HAVE READ THIS POWER OF ATTORNEY FOR HEALTH CARE. I <br />UNDERSTAND THAT IT ALLOWS ANOTHER PERSON TO MAKE LIFE AND DEATH <br />DECISIONS FOR ME IF I AM INCAPABLE OF MAKING SUCH DECISIONS. I <br />ALSO UNDERSTAND THAT I CAN REVOKE THIS POWER OF ATTORNEY FOR HEALTH <br />CARE AT ANY TIME BY NOTIFYING MY ATTORNEY -IN -FACT, MY PHYSICIAN, OR <br />THE FACILITY IN WHICH I AN A PATIENT OR RESIDENT. I ALSO <br />UNDERSTAND THAT I CAN REQUIRE IN THIS POWER OF ATTORNEY FOR HEALTH <br />CARE THAT THE FACT OF NY INCAPACITY IN THE FUTURE BE CONFIRMED BY <br />A SECOND PHYSICIAN. <br />a4 <br />RICHARD DALE GOETTSCH, Principal <br />DECLARATION OF WITNESSES <br />We declare that the principal is personally known to us, that <br />the principal authorized and directed B. J. CUNNINGHAM, JR. to sign <br />RICHARD DALE GOETTSCH's signature on this Durable General and <br />Health Care Power of Attorney for health care in our presence, that <br />the principal appears to be of sound mind and not under duress or <br />undue influence, and that neither of us nor the principal's <br />attending physician is the person appointed as Attorney in Fact by <br />this document. <br />Witnessed by: <br />Signature of Witne Date Printed Name of Witness <br />- Q Sicniature of Witness D alt a Printed Name of Witness <br />-4- <br />
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