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<br />200805306
<br />
<br />LAURITSEN', BROWNELL, BROSTROM, ~
<br />STEHLIK, MYERS & DAUGHERTY, PC, LLO nljpJ
<br />P. O. BOX 400 . ,.~, {j P
<br />GRAND ISLAND, NE 68801
<br />(308) 382-8010
<br />
<br />POWER OF ATTORNEY
<br />
<br />I, Donald H. Muhs, a domiciliary of Grand Island, Hall County, Nebraska, Principal,
<br />desiring and intending to establish a Power of Attorney operative under the Nebraska Short
<br />Form Act, do hereby appoint, constitute, and designate Dolores S. Muhs (and if she cannot or
<br />will not serve, I then appoint David J. Muhs and Douglas J. Muhs, jointly, as successor. If
<br />either cannot or will not serve, I then appoint the other as sole successor;) Agent, the lawful and
<br />true Agent and attorney in fact for Principal; 8ild Principal does hereby further provide and
<br />stipulate in connection therewith as follows:
<br />
<br />1. This Power of Attorney is, as marked, a
<br />( ) Durable Power of Attorney and a
<br />( ) Contingent Durable Power of Attorney, upon the contingency of,
<br />( ) Incompetence of Principal, or
<br />( ) Other Contingency: , or
<br />( X ) Present Durable Power of Attorney
<br />( ) Nondurable Power of Attorney.
<br />
<br />2. By this Power of Attorney, Principal confers upon and grants to Agent plenary
<br />power, plenary power subject to limitations, or all and each of the listed general powers as
<br />individually marked: .
<br />( X ) Plenary Power; or
<br />( ) Plenary Power Subject to Limitations, exclusive of General Powers for
<br />Domestic and Personal Concerns and for Fiduciary Relationships and
<br />( ) No Other Restrictions, or
<br />( ) Other Restrictions: ; or
<br />( ) General Power for Bank and Financial Transactions.
<br />( ) General Power for Business Interests.
<br />( ) General Power for Chattels and Goods.
<br />( ) General Power for Disputes and litigation.
<br />( ) General Power for Domestic and Personal Concerns.
<br />( ) General Power for Fiduciary Relationships.
<br />( ) General Power for Governmental and Other Benefits.
<br />( ) General Power for Insurance Coverages and Policies.
<br />( ) General Power for Proprietary Interests and Materials.
<br />( ) General Power for Real Estate.
<br />( ) General Power for Securities.
<br />( ) General Power for Records, Reports, and Statements.
<br />
<br />3. By this Power of Attorney, Principal makes the following additional provision or
<br />provisions: My Agent as my Personal Representative is authorized to execute any and all
<br />releases required by health care providers and health plans under HIPAA.
<br />
<br />4. This Power of Attorney revokes and supersedes all prior executed instruments
<br />of like import and remains operative until revoked.
<br />
<br />EXECUTED AT Grand Island, NE, on
<br />
<br />':) i.( ( (,/
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<br />
<br />,2004.
<br />
<br />STATE OF r.U:.BRASKA )
<br />) ss.
<br />COUNTY OF HAll )
<br />
<br />A' 1') /4'1-, )
<br />((].vc.t'd!)i ,)/~LJJ:~/
<br />Donald H. Muhs
<br />
<br />The foregoing instrument was acknowledged before me on
<br />by the Principal Donald H. Muhs.
<br />
<br />:;:/i. tl 'I
<br />I
<br />
<br />ell' ,2004,
<br />
<br />(~~: ) _i-: L/ . .I.
<br />-" \.. CA-;ffcf ,(./1 /'.~ __.1-il--t-HA.. t.~<-
<br />Notary Putl ic
<br />bEENERAl NOTARY - Slate 01 Nebraska .
<br />CHEAYll KOSMICKI
<br />.~j; -I. .1'w My Camm. Exp. March 5, 2006
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