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201106508
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Last modified
9/14/2011 12:36:35 PM
Creation date
9/2/2011 9:35:50 AM
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DEEDS
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201106508
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20110650� <br />been received by my attorney so that he has actual knowledge of the fact that I have died. Any <br />action taken in good faith by said attorney during any period while it is uncertain whether I am <br />alive, before he receives actual knowledge of my death, or, in any event, ta.ken during the period <br />while I am disabled or incapacitated, shall be as valid as if I were alive, competent, and not <br />disabled. <br />27. Controlling law. This Power of Attorney is to be a Nebraska Power to be <br />construed under the laws of the State of Nebraska. <br />28. Privacy Waiver. Regardless of the time of commencement of the other powers <br />granted my attorney-in-fact by this document, I authorize all physicians and psychiatrists who <br />have treated me, and all other providers of health care, including hospitals, to release to my <br />attorney-in-fact all information or photocopies of any records which my attorney-in-fact may <br />request. Any medical information released will serve the purpose of allowing my attorney-in- <br />fact to fulfill the obligations set forth in this document. All persons are authorized to treat any <br />request for information by my attorney-in-fact as the request of my personal representative and <br />to honor such requests as if they were my own. I hereby waive all privileges which may be <br />applicable to such information and records and to any communication pertaining to me and made <br />in the course of any confidential relationship recognized by law. My attorney-in-fact may also <br />disclose such information to such persons as my attorney-in-fact shall deem appropriate. I <br />understand that any information redisclosed by my attorney-in-fact is no longer protected by <br />federal privacy regulations covering health care providers. Furthermore, I understand that this <br />authorization for release of inedical information may be revoked in writing at any time, except to <br />the extent that the health care provider has taken action in reliance on the authorization. This <br />authorization for release of inedical information shall expire upon the earlier event of my naming <br />of a new attorney-in-fact for health care, or two (2) years following my death. This authorization <br />and request shall also be considered a consent to the release of such information under current <br />laws, rules and regulations as well as under future laws, rules and regulations and amendments to <br />such laws, rules and regulations to include but not be limited to the express grant of authority to <br />personal representatives as provided by Regulation Section 164.502(g) of Title 45 of the Code of <br />Federal Regulations and the medical information privacy law and regulations generally referred <br />to as HIPAA. <br />By the execution of this Durable Power of Attorney, I hereby specifically revoke and <br />rescind the previous Durable Power of Attorney dated January 11, 1999, wherein I designated <br />Alfred H. Petzoldt as my attorney-in-fact and Bruce A. Petzoldt as my successor attorney-in-fact, <br />and I hereby declare said Power of Attorney to be null and void and of no further force or effect <br />whatsoever. <br />IN WITNESS WHEREOF, I have signed and acknowledged this instrument this � <br />day of May, 2009. <br />7 I. Petzoldt <br />
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