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<br /> �nw�nC aY tbu� nnt . in�+�n�ionsl�.� cau�a�) my d�atln= k a a+►uGriur�,x�, .
<br /> cora�ent ta �nd arranq� �nr unrnnv�ntional p�in �e]�ie! thart�piMs
<br /> �lt�.ch my� 11q�nt be�.�.�v�• r�ti►y ba hslpt�b�. to �asl .
<br /> 7. ��r y�.�.�;:, :ls� ce�n;�.�n=t{sz�a r{e;��� �.n+► ±,��,.r.+�xr.r.i.c+rw�:i.v�e� �nciax _
<br /> thia J�xtiiale� rsl�a��s �a hprpit+�i eta�t, phyel.ai.�na�, nur�re� aind
<br /> otkxer n►edi.Cal and ho�pital adrnin��trativa personneZ whn ect in
<br /> reli�►x��e on, inatructic�ne giaen by tnx Agent or who xe�ndex wr3.tten
<br /> apiniona to r►y AgBn� in conn�ction with �ny mt�tter daecribed in . _
<br /> thie Articlo �ram a1]. 13a�bility fo� da.magee eut�e�ced ur to be
<br /> auf.�ered by me j ta s�.gn doauments t�.tX�d or purportiug to be a
<br /> "Refusnl to Permit Trea�ment" an.d "Leaving Hosg3taX Against Medi.�cal
<br /> Advice" ag �rell ae a►ny neaeaeary Wnive�e of Qx rel�a�ee Lran
<br /> li�iTia�t�},r aequired b}� any hoepi��l ar physic�.an +�cr ir.�rl��etta� my �
<br /> wi�sD�ers xegx►�ang �msc�x���. tx��a�txa�e�ntt a�� ma�n4treatmex�nt,
<br /> . ,ARTICI,g X
<br /> :."�.'.:' , � ,E,�;; � �.�u#�''.�At�.�D��d34.
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<br /> � :�G���.A�ent'3a aut�orizecE{tr::�.;�sup�3,.��^ra,-.:nt this instsumrnent by adding
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<br /> ar iiib�xfyizsc�;.xhe de�scziptio�n� .n�, a��i'property, rea�. or p�rar�nal, .
<br /> Mk11CI1 I i�l&y`���li'�' or herea�te��%�i�rtt1� 9in whole ax in �ar�;:ar�d �c� �en, � �
<br /> � �.� � '/•++�i .a.a . ��':'t4`.''t_ y`t � ..nnw.r•M.' �r ]�tf�u►�ir' '.h''h�ID� ., .
<br /> --. � Y'�tR�!l�u�.;��g��Q "�R.,�q�j�Sn.�ua.�4air�a..L� u"�`.6.w.i .a.a� s��i..�,.n:a�an.,, .n�, •,•—,•-T�+.—..-T:"'"•,'�_�_ : - � ..
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<br /> '� (j '�i,,. '�08:,��. �e�`�('!1�'ti�£ �:.ir1 �l5)��l. ���t�.�'fR��i -�t$��i��.Yl� ��+t�?'�kl`�'�Jl.�� 1��Y'�T7.�r�,•.�'r�C4 i {` .,
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<br /> ' '� ,: ..establimh� �{��nael, � cont�iur.�. ;,,�bir`,�,,;:��}�.t��i.�.J° •,r��,`;<'�'tty�+���t��. � ��.
<br /> __ , . a���za�3.ar�s and aasocia��ibri�a ,o,f ��11��.. l�inde, �'t;��G��k�.ari.d' gi.ve or ,
<br /> . . �iemy'`c�sstody Af al]. ot my iag►orC�ri�;. �acuaients, in��ud�.��,�but not ,
<br /> limited to my Nf.].1� cndicile, trust �greements, d�eds, lesesee, 2ife
<br /> ineuranct policiea� contractes and eecuri�3ee and to discloae or
<br /> retuse to disclo6e euch document�s� to obtain and relea►ee or .deny
<br /> ia#orma►tian ax recor�a of all kind� relating to ine� any �.n��reat of
<br /> mine ar to any pereon !�r Mhart I am responsiblef tc� houes or �
<br /> provide for hou�ing, euppc�rt aurid maintenance of auny ani.�aals or
<br /> � other iiving creaturee tT►at I taay a� a�nd to contract for amd pay �
<br /> � the expanaes di their prop�� v��teri.rdazy car� .and treata�n�; and if" ,
<br /> the care i�nd nwinCeaanae ot �uch animals or�"+ather 7:iving creaturee
<br /> " et�ll becuaae unreaeoxiably expeneive dr burc��nsome 3n my A�ent'g
<br /> opinion. to irrevo�a�bly tra►ngfer such animals tati�patae perac�n or
<br /> pereone Milling to care for and maintain t�em.
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<br /> �i��� p�.
<br /> My Agent ahall not chang� the benaf i.cia�ry of aay po13.�yr ox
<br /> pc�lici�� of la.fe insurance ox ret•Lreaien�, profit ehar�mg plan ox
<br /> e+mployee b�nefi�t o� Which I am the ir►sured, ea�p�.oyee-beneficiary or
<br /> o�rner, nor sha11 my Ag��nt exerciee any general power of apgdi.n�ment
<br /> or paWar to amend, revoke� all:er� or texa�.nate grant.ed or reserv�c�
<br /> ta me pnreuanC to any trust agxeement. l�r Agent sY�al].athexwise be
<br /> ' ' . authc�rized� xn geaneral to do all atih�r ac�s. deeds, mat�era, �nd
<br /> thinga whatsoever in or about my eRr�te, progerty anci af fairs nr to
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