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<br /> . � .:. �,> .,'.i...:,,.��°"_
<br />� g�op�r, ari� to �eceivo aazd gfve receipts gar any i�aome or dividend .' :�-�-_ :�:�r;;�;
<br /> •.'��c+.{.:•:-aL.:tc+h`rx,.
<br /> asi�i.ia� fscoffi su�� i�vss�aents, and to vary or dispose of all and ,�3 y4 ,,. _
<br />— a�y szac� �nve���s�r� or aY.YieP inves�n�� for my use an� benef it as :-
<br /> B� t��y �i.snk �a.�:. _ ' � ...._.... :-
<br /> - s,>
<br /> �.i*�5°a'�'�»}-,tprt9J'y:_,_�
<br /> l�. �,�`P �s at Sfiockholders� Meet�na� h'Mecut� Prox�es. and :�',;�, _°==°----4,
<br /> n�o'n,,������ a���i�.�te f�r Owner. 'so vote at the mestinqs of .-1_1i����:''
<br /> .:"�°—..Yr_-�_es�rirx-
<br /> s'�aa'�?�a3.�� as ot.Pisr aae�ings of an� corporation or company, or , �.�� _
<br /> ot.��+ui�e t.� a��. as my attorn�y or progy, cvit.� power of ,�_, s,���A.=-�=---_�"-�"�_�
<br /> szab��itcr,�tian, i.ia���ss���'t of any stocks, shares, bon=ie, d�bentures, - ��.� -
<br /> � ��. �w���,�e� Qg o�rship, or securi�fes, now or h�rea�te� _�.;.�;-.:_
<br /> Baal�l �y ��► � ���ed by or an account of said corporation o� ������_----`—
<br /> c��yY � i��• �i�t pu�cpose to execute amy proxiQS, aimitad or 'TT���„� �.��
<br /> ga�v�za3., a� a�te�r instruments. ~'��='�`���� ".-�'�`
<br /> ��:W "" f
<br /> tes arsd Similar Instrum�ntse "'�"�%"'��=`�1°��
<br /> 11.. T,�'s ��cute Reecl� Bills Na � �p,�.
<br /> «;.
<br /> F��e a11 � ��. af the purposes herein stated to enter fnto and �� _ ''r�.�t^:
<br /> sign, se�7L, �z�c�xte, acknawledqQ, � deliver ar►y contrac�ts, deec� �- i�. � ,�,
<br /> v� uYhar ixt�.�r�nts ctha�so@vc��. �nd to draFr, acc�pt, maIte, - .. ,� ,
<br /> r -�-
<br /> er�cla�s, di��ar�rni�, or otherwise d�al with any commercial os �;�. i+�i=�=�:
<br />_ ;� r�or�:nti3c irr.�ra�inen�so �"'`�,'_-
<br /> ��_�:��':�
<br /> ; 1�. �o Cca��azt� to Medical T�eatm�n�. To exercise fuT3l right
<br /> '�.��•��`.���
<br />, aa�i �.a•.x�i.nl ao����i.ty to make and ex�cu�e all me�cal c�c-�isions �1�� ��, .
<br /> c�ao�i�j tng pexson, inaluding, buL not limited to the ���ction � ,,�: �
<br /> of p��•yici�,^, and heal�h caae services, and the use, withDcsS�i!�g or ;, .. ,��,..
<br /> h
<br /> cai.sao��i�eti�e of inechanical or other life-suppart syst�� and I y� ' '.;�'�: �� "
<br /> ��s,rr�by �ia:��t� that all physicians and other health care g��el � ���
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<br /> sh�1:.�. aa'� �mw�auan� to �hhe olirectidrn af my attornay�in-fact. :�.. '�
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<br /> �t is to be undorstood, .aowr��o �hat I hav� strong � - , =
<br /> � ob��acticttr»a� 2o the a8ministration of inedical �reatinent to any pe�son �.,.
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<br /> s�l:+�ly fo9e� the p�arpose o f presesw i nq t h a t p e r s o n's l�f e, w h e n �h e A� � ��_ _
<br /> . ' gs�z.l�.�cr��:�=�ated is naither phyefcally abae, a�or m�nically competent, - - ,-==—i
<br /> td ercj.a�� fcurther life. I therefore request tt:at my attorney-in-- �� _•�
<br /> �: N J ��C.__.
<br /> _ ''� �'"L—`_�'__
<br /> � �aut, h+�s �ided by this expreasio�a of my wishes. If I am physically �r�,����.�..f,,�Y_,
<br /> �x�n�bi�a �+:s eare f�or mysel� without cosastant help, and mentally ,,;,,-,r,�F,
<br /> • 3,n��p�tc-�4�tt to unc3erat�nd my conxlitfon anc� recognize those abou� -�_•� �-���y��::
<br /> ' ��,. �tci. �y physicat and mental cai�dit�f.oa cannot be significantly ---- -��_.
<br />;;��� � ��tr�ved by further treatmer�t, tt�.� I request that no trea�en'k �� -- _
<br />'� inU�x�dac��solely to prolong my life b� applfed, and that my life be �.,.;
<br /> �rr�f��� to end without medical interference. nw.��. _ :v_.,-=-M.-
<br /> .I ,'_" r,,,e4,�„�,� -;
<br /> �, -� It shouidl be understoasl that tbis statement is not ����•. � �
<br /> �.ttL�z�l�ed as a co�zg2�ate re jection af ineafcal treatm�nt intended to � ��i;•' ° ,�. �.,.�,
<br /> rol�mv� paia, or r��daticsn useful in proviAinq for my care �e��fng a • -�`' � �
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<br /> � term3.s�al i2l�ess, but it is intendPd to re�rent the a ai�,Lion of � ��� ��
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<br /> � oxygen+ i�.i:�.-�veae�us feeding and c�imilar tr��ianents intende� solely �,`;�,�.,��;��,.-_
<br /> �a� mafn�c�r��s�ce, aaLr�n no siqnifi�:t poss�lr+flity c� imp�ovem�nt in � ' • - -:.°--m;,,�;:,__
<br /> .m� �ndi�fo� 13 �u�dseen. It i�a � cvisA that no ��aatment be, ��:�"-RT'°�:`�`4i;
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