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202005711
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Last modified
8/7/2020 9:49:30 AM
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8/7/2020 9:49:28 AM
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DEEDS
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202005711
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20057,E <br />ARTICLE VIII <br />RESTRICTION ON POWERS <br />Restriction on Powers. Notwithstanding any provision herein to the contrary, my Agent <br />shall: i) have no power or authority whatsoever with respect to any interest in or incidents of <br />ownership in any policy of insurance I may own on the life of my Agent; ii) have no power or <br />authority whatsoever with respect to (a) any irrevocable trust created by my Agent as to which I <br />am a trustee or a beneficiary, or (b) any asset given to me by my Agent; iii) be prohibited from (a) <br />appointing, assigning, or designating any of my assets, interests, or rights directly or indirectly to <br />my Agent, my Agent's estate, my Agent's creditors, or the creditors of my Agent's estate, (b) <br />exercising any powers of appointment I may hold in favor of my Agent, my Agent's estate, my <br />Agent's creditors, or the creditors of my Agent's estate, (c) disclaiming assets to which I would <br />otherwise be entitled if the effect of such disclaimer is to pass assets directly or indirectly to my <br />Agent or his or her estate, or (d) using my assets to discharge any of my Agent's legal obligations, <br />including any obligation of support which my Agent may owe to others, excluding those whom I <br />am legally obligated to support; iv) be prohibited from exercising any discretionary fiduciary <br />powers that I now hold or may hereafter acquire; and v) avoid disrupting the dispositive provisions <br />of any estate plan of mine known to my Agent. <br />ARTICLE IX <br />DURABILITY PROVISION <br />Immediate Power. This power of attorney shall not be affected by the Principal's <br />subsequent disability or incapacity or lapse of time. <br />(1) Current Authorization for Agent to Obtain Health Care Information. <br />Notwithstanding any other provision in this Durable Power of Attorney to the contrary and <br />effective immediately, I do hereby authorize all health care providers, including, but not limited to, <br />hospitals, nursing homes, treatment facilities, and other covered entities, and all physicians, <br />nurses, therapists, and other persons who may have provided in the past, or are currently providing, <br />the undersigned with any type of medical, mental, or other types of health care, to disclose to my <br />Agent, as my HIPAA personal representative, and any other successor HIPAA personal <br />representative all information, medical information, psychiatric records, psychiatric notes, and <br />other "protected health information" for the purpose of determining my capacity as defined in this <br />powers of attorney, making health care decisions on my behalf, or as may be required or permitted <br />by state law. The HIPAA personal representative may also give this authorization to substitute <br />individuals to so act in addition to such HIPAA personal representative. This authorization is <br />intended to provide my health care providers with the authorization necessary to allow each of <br />them to disclose such general medical information and protected health information regarding me <br />to the above designated agents. The information disclosed by any such health care provider <br />pursuant to this authorization is subject to further disclosure and use by such designated agents and <br />may thereafter no longer be protected by such privacy rules. This authorization shall remain in <br />effect until the earlier of its revocation by me or my death. <br />Durable Power of Attorney for Janice S. Nikodym Page 10 <br />
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