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202205853
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8/8/2022 4:05:47 PM
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8/8/2022 4:05:46 PM
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202205853
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202205853 <br />GRANT OF SPECIFIC AUTHORITY: My agent MAY NOT do any of the following specific acts for me UNLESS I have <br />INITIALED the specific authority listed below: (CAUTION: Granting any of the following will give your agent the authority to <br />take actions that could significantly reduce your property or change how your property is distributed at your death. INITIAL <br />ONLY the specific authority you WANT to give your agent.) <br />( ) Create, amend, revoke, or terminate an inter <br />vivos trust <br />( ) Make a gift, subject to the limitations of the <br />Nebraska Uniform Power of <br />Attorney Act and any special instructions in this <br />power of attorney <br />( ) Create or change rights of survivorship <br />( ) Create or change a beneficiary designation <br />( ) Delegate to another person to exercise the <br />authority granted under this power of attorney <br />(_) Waive the principal's right to be a beneficiary of a <br />joint and survivor annuity, including a survivor <br />benefit under a retirement plan <br />( ) Exercise fiduciary powers that the principal has <br />authority to delegate <br />( ) Renounce or disclaim an interest in property, <br />including a power of appointment <br />LIMITATION ON AGENT'S AUTHORITY: Except as otherwise authorized by the Power of Personal and Family <br />Maintenance, an agent MAY NOT use my property to benefit the agent or a person to whom the agent owes an obligation of <br />support unless I have included that authority in the Special Instructions or the Grant of Specific Authority. <br />SPECIAL INSTRUCTIONS (OPTIONAL): You may give special instructions on the following lines: <br />This Power of Attorney revokes all prior Durable Powers of Attorney which I have signed. <br />EFFECTIVE DATE: This power of attorney is effective upon my signature. <br />NOMINATION OF CONSERVATOR OR GUARDIAN: If it becomes necessary for a court to appoint a conservator of my <br />estate or guardian of my person, I nominate the following person(s) for appointment: LeRoy E. Johnson. <br />RELIANCE ON THIS POWER OF ATTORNEY: Any person, including my agent, may rely upon the validity of this power of <br />attorney or a copy of it unless that person knows it has terminated or is invalid. <br />SIGNATURE AND ACKNOWLEDGMENT <br />Darlene Layher <br />Date <br />STATE OF NEBRASKA ) <br />) ss: <br />COUNTY OF HALL ) <br />/.1 <br />This document was acknowledged before me on June ,_'7 22, by Darlene Layher. <br />�4Z #06-1,9'i-44,--...— <br />Notary Public <br />My commission expires: <br />GENERAL NOTARY .-State of Nebraska <br />pump A BURNS <br />My Comm. Exp. March 28,2824 <br />ERICKSON LAW, LLC, 308 N. Locust Street, Suite 312, Grand Island, NE 68801 <br />Page 2 <br />
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