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200405690
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Last modified
10/16/2011 5:05:44 PM
Creation date
10/21/2005 1:54:06 AM
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DEEDS
Inst Number
200405690
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My attorney -in- fact/agent hereby accepts this appointment subject to its terms and agrees to act <br />and perform in said fiduciary capacity consistent with my best interests as he /she in his/her best <br />discretion deems advisable, and I affirm and ratify all acts so undertaken. <br />TO INDUCE ANY THIRD PARTY TO ACT HEREUNDER, I HEREBY AGREE THAT ANY THIRD <br />PARTY RECEIVING A DULY EXECUTED COPY OR FACSIMILE OF THIS INSTRUMENT MAY <br />ACT HEREUNDER, AND THAT REVOCATION OR TERMINATION HEREOF SHALL BE <br />INEFFECTIVE AS TO SUCH THIRD PARTY UNLESS AND UNTIL ACTUAL NOTICE OR <br />KNOWLEDGE OF SUCH REVOCATION OR TERMINATION SHALL HAVE BEEN RECEIVED BY <br />SUCH THIRD PARTY, AND I FOR MYSELF AND FOR MY HEIRS, EXECUTORS, LEGAL <br />REPRESENTATIVES AND ASSIGNS, HEREBY AGREE TO INDEMNIFY AND HOLD HARMLESS <br />ANY SUCH THIRD PARTY FROM AND AGAINST ANY AND ALL CLAIMS THAT MAY ARISE <br />AGAINST SUCH THIRD PARTY BY REASON OF SUCH THIRD PARTY HAVING RELIED ON THE <br />PROVISIONS OF THIS INSTRUMENT. <br />Signed under seal this day of <br />Signed in the presencd of: <br />Witness <br />Witness <br />1" AJ C 20 UV <br />Grantoor�� J 'n <br />QA <br />Attorney- in- Fact/Agent 0 �— <br />State of /✓& a )9--5 k A <br />County of -/J& /-,L I <br />On `i before me, Z, O R E 77-,q 7-�V0,Y) A-1 appeared <br />, personally known <br />to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is /are subscribed to <br />the within instrument and acknowledged to me that he /she /they executed the same in his/her /their authorized capac- <br />ity(ies), and that by his/her /their signature(s) on the instrument the person(s), or the entity upon behalf of which the <br />person(s) acted, executed the instrument. <br />WITNESS my hand and official seal. <br />Signature <br />GENERAL NOTARY - State of Nebraska <br />CHERYL L KOSMICKI <br />My Comm. UP. March 5, 2006 <br />Page 2 <br />Affiant Known Produced ID <br />Type of ID <br />(Seal) <br />I <br />O <br />200405690 <br />[ Olt ] <br />(H) <br />Claims and litigation <br />(I) <br />Personal relationships and affairs <br />[ 7- ] <br />(J) <br />Benefits from military service <br />(K) <br />Records, reports and statements <br />(L) <br />Full and unqualified authority to my attorney -in- fact/agent to delegate any or all of the <br />foregoing powers to any person or persons whom my attorney -in- fact/agent shall select <br />(M) <br />Access to safe deposit box(es) <br />[ ] <br />(N) <br />To authorize medical and surgical procedures (Pennsylvania only) <br />[ T ] <br />(0) <br />All other matters <br />Durable Provision: <br />(P) <br />If the blank space in the block to the left is initialed by the Grantor, this power of attorney <br />shall not be affected by the subsequent disability or incompetence of the Grantor. <br />Other Terms: <br />My attorney -in- fact/agent hereby accepts this appointment subject to its terms and agrees to act <br />and perform in said fiduciary capacity consistent with my best interests as he /she in his/her best <br />discretion deems advisable, and I affirm and ratify all acts so undertaken. <br />TO INDUCE ANY THIRD PARTY TO ACT HEREUNDER, I HEREBY AGREE THAT ANY THIRD <br />PARTY RECEIVING A DULY EXECUTED COPY OR FACSIMILE OF THIS INSTRUMENT MAY <br />ACT HEREUNDER, AND THAT REVOCATION OR TERMINATION HEREOF SHALL BE <br />INEFFECTIVE AS TO SUCH THIRD PARTY UNLESS AND UNTIL ACTUAL NOTICE OR <br />KNOWLEDGE OF SUCH REVOCATION OR TERMINATION SHALL HAVE BEEN RECEIVED BY <br />SUCH THIRD PARTY, AND I FOR MYSELF AND FOR MY HEIRS, EXECUTORS, LEGAL <br />REPRESENTATIVES AND ASSIGNS, HEREBY AGREE TO INDEMNIFY AND HOLD HARMLESS <br />ANY SUCH THIRD PARTY FROM AND AGAINST ANY AND ALL CLAIMS THAT MAY ARISE <br />AGAINST SUCH THIRD PARTY BY REASON OF SUCH THIRD PARTY HAVING RELIED ON THE <br />PROVISIONS OF THIS INSTRUMENT. <br />Signed under seal this day of <br />Signed in the presencd of: <br />Witness <br />Witness <br />1" AJ C 20 UV <br />Grantoor�� J 'n <br />QA <br />Attorney- in- Fact/Agent 0 �— <br />State of /✓& a )9--5 k A <br />County of -/J& /-,L I <br />On `i before me, Z, O R E 77-,q 7-�V0,Y) A-1 appeared <br />, personally known <br />to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is /are subscribed to <br />the within instrument and acknowledged to me that he /she /they executed the same in his/her /their authorized capac- <br />ity(ies), and that by his/her /their signature(s) on the instrument the person(s), or the entity upon behalf of which the <br />person(s) acted, executed the instrument. <br />WITNESS my hand and official seal. <br />Signature <br />GENERAL NOTARY - State of Nebraska <br />CHERYL L KOSMICKI <br />My Comm. UP. March 5, 2006 <br />Page 2 <br />Affiant Known Produced ID <br />Type of ID <br />(Seal) <br />I <br />
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