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20210518n <br />L. Yes 0 No Retirement Plans <br />Yes i No Q.V\ Taxes <br />Ves i No CAA All Preceding Subjects <br />GRANT OF SPECIFIC AUTHORITY (OPTIONAL) <br />My agent MAY do any of the following specific acts for me IF 1 have CHECKED the specific authority <br />listed below: <br />(CAUTION: Granting any of the following will give your agent the authority to take action that could <br />significantly reduce your property or change how your property is distributed at your death, CHECK <br />YES AND INITIAL ONLY the specific authority you, WANT to give your agent. NOTE: If you <br />do not nark yes and initial the authority, the authority is not granted.) <br />Check one,: Initials: <br />Ycs No /� \ Create, amend, revoke, or terminate an inter vivos trust <br />Y Ycs No l/� Make a gift, subject to the limitations of the Nebraska Uniform <br />Power Attoii ey Act and any special instructions in this power or attorney <br />f Ycs No CO Create or change rights or survivorship <br />Yes L No C Create or change a beneficiary designation <br />LYes No ti'\ Delegate to another person to exercise the authority granted under <br />this power of attorney. <br />kr-Cc's No C1✓\ Waive the principal's right to be a beneficiary or a joint and <br />,.� survivor annuity, including a survivor benefit under a retirement plan <br />Yes No C/�"- Exercise fiduciary powers that the principal has authority to <br />delegate <br />C9es 0 No (`�. Renounce or disclaim an interest in property, including a power of <br />appointment. <br />LIMITATION ON AGENT'S AUTHORITY <br />if i did not check the "Power of Personal and Family Maintenance" or the "All Preceding Subjects" in <br />the Grant of General Authority above, my agent MAY NOT use my property to benefit themselves or <br />anyone they support except for those items listed below in the Special Instructions. <br />SPECIAL INSTRUCTIONS <br />You may give special instructions in the following space: <br />1, Carlos J. Martinez, specifically grant Delialh Catalina Lazo the authority to sell my home located at <br />1011 North Walnut Street, Grand Island, NE 68801. She is authorized to sign any documents that are <br />2 of 3 <br />