200709483 - Laserfiche WebLink

Browse

~,' f " .t; ~ 1-. i . I 1.' t, I 200709483 13. POWER OF ATTORNEY EFFECTIVE NOTWITHSTANDING DISABILITY OF PRINCIPAL; CONTINUES IN EFFECT AFTER PRINCIPAL'S DEATH UNTIL NOTICE. Pursuant to the provisions of Sections 30-2664 and 30-2672, R.R.S. 1989, I declare that this power of attorney shall not be affected by my disability or incapacity, and that the authority granted herein shall continue during any period which I am disabled or incapacitated. Further, pursuant to said Sections, all such authority shall continue after my death, until notice of such death shall have been received by my attorney in fact so that my attorney in fact has actual knowledge of the fact that I have died. Any action taken in good faith by said attorney during any period while it is uncertain whether I am alive, before my attorney in fact receives actual knowledge of my death, or, in any event, taken during any period while I am disabled or incapacitated shall be as valid as if! were alive, competent, and not disabled. An affidavit produced by my attorney will be considered conclusive proof that my attorney in fact acted in good faith. In the event a court of my domicile appoints a conservator, guardian of the estate, or other fiduciary to be charged with the management of all my property, I hereby nominate my attorney named herein to serve as said conservator or guardian. I hereby request that any court make such appointment in accordance with this nomination. 14. My said attorney in fact shall have access to any safe deposit box that I may own either at the time of the execution of this power of attorney or subsequent thereto with the right to remove and add to the contents of said safe deposit box. 15. Words in this Power of Attorney in the singular shall be deemed to include plural, and the plural the singular. 16. In the event that Randall Edward Jarzynka is unable or unwilling to serve, I then nominate and appoint Gayle Verbeck as said attorney in fact with the same powers as those granted to Randall Edward Jarzynka. 17. I authorize my attorney in fact appointed by this document to make health care decisions for me when I am determined to be incapable of making my own health care decisions. I have read the warning which accompanies this document and understand the consequences of authorizing my attorney in fact to make health care decisions for me. I have communicated with my attorney in fact my thoughts and wishes with respect to the continuation oflife support and the performance of "heroic" measure to sustain life. I direct that my attorney in fact shall have the authority to make all decisions respecting medical measures in the event my health necessitates the making of such decisions when there is no significant possibility of improvement in my condition as determined by my attending physician, after such medical consultation as my attending physician may desire. In the event that I am in a terminal condition and there is no significant possibility of improvement of my condition as determined by my attending physician, then my attorney in fact shall have authority to direct and consent to the withholding or withdrawing of life sustaining treatment that is not necessary for my comfort or to alleviate pain. NOTICE I HAVE READ THIS DURABLE POWER OF ATTORNEY FOR HEALTH CARE. I UNDERSTAND THAT IT ALLOWS ANOTHER PERSON TO MAKE LIFE AND DEATH DECISIONS FOR ME IF I AM INCAPABLE OF MAKING SUCH DECISIONS. I ALSO UNDERSTAND THAT I CAN REVOKE THIS DURABLE POWER OF ATTORNEY FOR HEALTH CARE AT ANY TIME BY NOTIFYING MY ATTORNEY IN FACT, MY PHYSICIAN, OR THE FACILITY IN WHICH I AM A PATIENT OR RESIDENT. I ALSO UNDERSTAND THAT I CAN REQUIRE IN THIS POWER OF ATTORNEY FOR HEALTH CARE THAT THE FACT OF MY INCAPACITY IN THE FUTURE BE CONFIRMED BY A SECOND PHYSICIAN. IN WITNESS WHEREOF, I have signed and acknowledged this instrument this -J-- day of May, 2007. (j~L."i ~ ~. Char s L' Rrzynka STATE OF NEBRASKA ) ) ss. COUNTY OF LINCOLN ) BE IT KNOWN, that on the L day of May, 2007, before me personally appeared Charles L. Jarzynka, above named, who is to be known to be the person described in and who executed the above Durable Power of Attorney, and acknowledged the same to be his voluntary act and deed. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed my official seal, the day and year Ia" above written. . . ~..' . GENERAL NOTARY. State of Nebraska ~/<C~'"\- i MICHAEL L NOZICKA Notary Pubhc My COmm. Exp. July 17, 2007 Prepared By: Michael L. Nozicka NOZlCKA LA W OFFICE 515 North Dewey North Platte, Nebraska