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NOMINATION OF CONSERVATOR OR GUARDIAN (OPTIONAL) <br />If rt Oecornes necessary' for a court to appoint 3 conservator af niy es <br />'Person I roommate the foilovving person,: so fo' "appointment <br />NXT't Of ')(:;rttlriee for coroservator of 171V estate <br />• <br />N.cgreineers ayjc'h,coois .4, <br />NOntiliL'e S teleohorie nLortoper r • -L4ro:' <br />Narre of norrome.e for go.,,;archan of my person <br />— — <br />Norrinc,,e's address roroorol 'or or <br />No'orroohee's telephone fluff-10er orrr roltortr- <br />202105214 <br />,r guardian of <br />RELIANCE ON THIS POWER OF ATTORNEY <br />y <br />Ar,V perSCn q)(::!UCling fry' agent gray rery upon toe validity of this power of attorney ar a <br />sd.Hus s that pfrson knows it has ter trimatec or os rvand <br />SIGNATURE AND ACKNOWLEDGMENT <br />Yc,ir s grtat,41fr <br />Your 'tame o'oted <br />Ya,,ir ajar esS <br />'how teoephorone narhber <br />1 IT ( ( ()I( ‘I <br />1 I 1()1 (111(11 'MN ()I. 11 I ()ICS' rage 4 of 6 <br />