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`''02100578 <br />RELEASE OF INFORMATION <br />I agree to, authorize and allow full release of information, by any governmental agency, business, <br />creditor, or third party who may have information pertaining to my assets or income, to my agent <br />named herein. <br />GRANT OF GENERAL AUTHORITY <br />I grant my agent and any successor agent general authority to act for me with respect to the following <br />subjects as defined in the Uniform Power of Attorney Act, Nebraska Revised Statutes Sections 30- <br />4001, et seq. <br />(INITIAL each subject you want to include in the agent's general authority. If you wish to grant <br />general authority over all of the subjects you may initial "All Preceding Subjects" instead on <br />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 />( ) Estates, Trusts, and Other Beneficial Interests <br />( ) Claims and Litigation <br />( ) Personal and Family Maintenance <br />( ) Benefits from Governmental Programs or Civil or Military Service <br />( ) Retirement Plans <br />( ) Taxes <br />(T/Q ) All Preceding Subjects <br />GRANT OF SPECIFIC AUTHORITY (OPTIONAL) <br />My agent MAY NOT do any of the following specific acts for me UNLESS I have INITIALED the <br />specific authority listed below: <br />(CAUTION: Granting any of the following will give your agent the authority to take actions that <br />could significantly reduce your property or change how your property is distributed at your death. <br />INITIAL ONLY the specific authority you WANT to give your agent.) <br />( ) Create, amevo , or terminate an intervivos trust <br />( ) Make a gi , u to the limitations of the Uniform Power of Authority Act [insert citation <br />to Section 217 of ctj and any specific Instructions in this power of attorney <br />