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202102166 <br />NOMINATION OF (CONSERVATOR OR GUARDIAN) (OPTIONAL) <br />If it becomes necessary fora court to appoint a conservator or guardian of my estate or of <br />my person, I nominate the following persons) for appointment: <br />Name of Nominee: Ralph R. Kaiser <br />Nominee's Address: 824 W. 10th St., Grand Island, NE 68801 <br />Nominee's Telephone Number: 308-675-0438 - <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 <br />copy of it unless that person knows it has terminated or is invalid. <br />SIGNATURE AND ACKNOWLEDGMENT <br />16)' <br />Si a°24 Date <br />Printed Name Ronald W. Kaiser <br />Address Heritage House, 1920 Sagewood Ave., Grand Island, NE 68803 <br />Telephone Number 402-519-4959 <br />STATE OF NEBRASKA <br />SS: <br />COUNTY OF HALL <br />This document was acknowledged before me on / - (5 -a0 by <br />Ronald W. Kaiser. <br />My commission expires: <br />r , <br />(Seal, if any) <br />This document prepared by: <br />Zachary Butz #24922 ' <br />WOLF, McDERMOTT, DEPUt, SABOTT, <br />BUTZ & PORTO, LLC <br />308 N. Locust St., Suite 501 <br />Grand Island, NE 68801 <br />(308) 384-1635 <br />