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202402918 <br />LIMITAnON ON AGUT o rt, <br />If I did not check the 'Power of Personal and Family Maintenance" or the "All Preceding <br />Subjects' in the Grant of General Authority above, my agent MAY NOT use my property to <br />benefit themselves or anyone they support except for those items listed below in the <br />Speaal Instructions. <br />SPECIAL INSTRUCTIONS (OPTIONAL) <br />You may give special instructions in the following space: <br />NOMINATION OF [CONSERVATOR OR GUARDIAN] (OPTIONAL) <br />If it becomes necessary for a court to appoint a conservator of my estate, I nominate the <br />following person(s) for appointment: <br />Name of 3 nominee for conservator of my estate: L (ni I} 20 Se, et,LA7 /4-C) <br />Address: tin 2 W i2`� s+� C�rand rst a 'ter ems <br />Telephone Number 13010 `gSv <br />If it becomes necessary for a court to appoint a guardian of my person, I nominate the <br />following person(s) for appointment: <br />Name of nominee for guardian of my person: 14J ► Ct eerre -2tteStr 1 <br />Address: 1 '32. w 12,4 54 41(4 lid S31O 3 <br />Telephone Number. (Sob) 8'S0 3414 <br />REUANCE ON THIS POWER OF ATTORNEY <br />Any person, induding my agent, may rely upon the validity of this power of attorney or a copy <br />of it unless that person knows it has terminated or is invalid. <br />EFFECTIVE DATE: This power of attorney is effective immediately unless I have stated <br />otherwise in the special Instructions. <br />TERMINATION: I understand this power of attorney ends immediately upon my death. <br />Power of Attorney, DC 8:12 PSC, Rev. 1112023 § 30-4041 <br />Page 3 of 4 <br />