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Surro•ate Decision Makin <br />'•iaska <br />SIGNATURE AND ACKN <br />(CAUTION: This document <br />Uniform Power of Attorney A <br />202401880 <br />Nebraska State Unit: or r • <br />DGMENT <br />be signed IN THE PRESENCE of a notary to comply with the Nebraska <br />Date <br />Your Signature <br />h 'r.cSMI' 5, <br />Your Name Printed <br />,3o 3. <br />Yaw Address <br />)J& Q'i-' <br />-5o-5Fia.sSW <br />Your Phone Number <br />NOTARY <br />State of Nebraska <br />[County] of Rai t <br />This document was acknowledged before me on <br />by_ <br />5\f)e---r•e../ bJ • 51 yr) <br />Name of Principal <br />(4) bCO, t <br />Signature of Notary <br />.e ruo,r-\ 8, a� t) 3 <br />My commission expires:-ber1'v'bgr 9. ,Q04/ <br />Power of Attorney, DC 6:12 PSC, Rev. 08/12 §30-4041 <br />(Seal, If any) <br />GENERAL NOTARY -State of Nebraska <br />LISA BUTLER <br />L,p <br />`"Ee; My Cnmm. Cep. Dec, 9.2024 <br />MLTC•PB-S {09009) 2/21 <br />