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202208650
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Last modified
12/16/2022 4:40:44 PM
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12/16/2022 4:40:43 PM
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202208650
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202208650 <br />•NEBRASKA STATUTORY FORM POWER OF ATTORNEY . <br />• MARIAN M. HEIVSLEY • . <br />, IMPORTANT INFORMATION . <br />• , This power of attorney authorizes another person (your agent) to make decisions concerning your property for you • <br />(the principal). Your agent will be able to make' decisions and act with respect to your property (including your <br />money) whether or not you are able to act for yourself. The meaning .of authority over.subjects listed on this form is <br />explained in the Nebraska Uniform Power of Attorney Act. • <br />• This power of attorney does not authorize the agent to make health care decisions for you. <br />• •You •should select someone you trust to serve•as your agent.. Unless you specify otherwise; generally the,agenf s • <br />authority will continue until you die or revoke the power of attorney or the agent resigns 'or Is" unable to act for•you. <br />• This form will not revoke a power of attbrney previously executed by you unless you add that the previous power of • <br />attorney is revoked or that all other powers of attorney are revoked by this power of attorney. . <br />• Your agent is entitled to reasonable compensation unless you state otherwise in the Special instructions.. <br />• This form' provides for designation of one agent. If you wish to name more than one -agent you may name a co- <br />agent In the Special Instructions. Co -agents are not mulled to act together unless you include that requirement in• <br />the Special Instructions. . <br />• If your agent Is unable or unwilling to act for you, your power of attorney will end .unless you have named a <br />successor agent; .You may also name a second successor agent. <br />® If you have questions about the power of attorney or the authority you are granting to. your agent, you should seek <br />. • legal advice before signing this form. <br />• DESIGNATION 'OF AGENT: 1, Marian M. Hensley (principal) name the following person as my agent: Kay M. Carpenter " <br />. " and Ann C. Bentley. <br />• DESIGNATION OF SUCCESSOR AGENT: if my agent is unable or unwilling to act for nie, ! name as my successor.agent: <br />• RELEASE OF INFORMATION: I agree to, authorize, and allow full. release of information, by any governmental agency, <br />.business, creditor, or third party who may have Information pertaining to my assets or Income, to my agent named her cin, <br />GRANT OF GENERAL AUTHORITY: .1 grant my 'agent and any successor agent durable general authority to act for me <br />with respect to the following subjects as defined in the Nebraska Uniform Power of Attorney Act: (INITIAL each subject you <br />want, to include in the agent's geherai authority. If you wish to grant general authority over all of the subject you' may <br />initial "All Preceding Subjects" Instead of 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 Beneflc€ai'€nterests. <br />( ' ) Claims and Litigation <br />. (,) Personal and Family Maintenance <br />( • ) Benefits from Governmental Programs or Civil or <br />Military Service <br />( .) Retirement Plans <br />( ) Taxes <br />Waif) All Preceding Subjects <br />• GRANT OF SPECIFIC AUTHORITY:. My agent MAY NOT do any of the following specific acts forme UNLESS 1 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 15 distributed at your death. INITIAL, • <br />ONLY the specific authority you WANT to give your agent.). <br />MAYER BUMS KOBNIG & JANULEWICZ, 308 N. Locust Street, Suite 306, PO Box 2300, Grand Island, NE 68802 <br />Page l <br />
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