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202504 77 GRANT OF SPECIFIC AUTHORITY: My agent MAY NOT do any of the following specific acts for me UNLESS I have INITIALED the specific authority listed below: (CAUTION: Granting any of the following will give your agent the authority to take actions that could significantly reduce your property or change how your property is distributed at your death, INITIAL ONLY the specific authority you WANT to give your agent.) ) Create, amend, revoke, or terminate an inter vivos trust Make a gift, subject to the limitations of the Nebraska Uniform Power of Attorney Act and any special instructions in this power of attorney ( ) Create or change rights of survivorship ( ) Create or change a beneficiary designation ( ) Delegate to another person to exercise the authority granted under this power of attorney ( ) Waive the principal's right to be a beneficiary of joint and survivor annuity, including a survivor benefit under a retirement plan ( ) Exercise fiduciary powers that the principal has authority to delegate ( ) Renounce or disclaim an interest in property, including a power of appointment LIMITATION ON AGENT'S AUTHORITY: Except as otherwise authorized by the Power of Personal and Family Maintenance, an agent MAY NOT use my property to benefit the agent or a person to whom the agent owes an obligation o support unless I have included that authority in the Special Instructions or the Grant of Specific Authority. SPECIAL INSTRUCTIONS (OPTIONAL); You may give special instructions on the following lines: EFFECTIVE DATE: This power of attorney is effective only upon a determination that I am incapacitated, NOMINATION OF CONSERVATOR OR GUARDIAN: If it becomes necessary for a court to appoint a conservator of m estate or guardian of my person, I nominate the following person(s) for appointment: RELIANCE ON THIS POWER OF ATTORNEY: Any person, including my agent, may rely upon the validity of this power of attorney or a copy of it unless that person knows it has terminated or is invalid. 47 ((MI Amy Em ly Folkers STATE OF NEBRASKA COUNTY OF HALL ) ) ss: SIGNATURE AND ACKNOWLEDGMENT Date This document was acknowledged before me on January My commission expires: GENERALka JFROM E. JANULEWICZ My Comm, Exp. Jan,10, 2D15 2014, by y Emily Folkers. Not.., `ublic MAYER BURNS KOENIG & JANULEW1CZ, 308 N. Locust Street, Suite 306, PO Box 2300, Grand island, NE 68802 Page 2