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t <br />201108699 <br />[,� ](I� Benefits &om Social Secarity, Medicare, Medicaid, or other <br />governmental programs, or military service. To prepare, sign and file any claim or <br />application for Social Security, unemployment or military service benefits; sue for, settle <br />or abandon any clauns to any benefit or assistance under any federal, state, local or <br />foreign statute or regulation; control, deposit to any account, collect, receipt for, and take <br />title to and hold a11 benefits under any Social Security, unemployment, military service or <br />other state, federal, local or foreign staiute or regulation; and, in general, exercise all <br />powers with respect to Social Security, unemployment, military service, and <br />governmental benefits, including but not limited to Medicare and Medicaid, which the <br />principal could exercise if present and under no disability. <br />[� ](L) Retirement plan transactions. To contribute to, withdraw from and <br />deposit funds in any type of retirement plan (which term includes, without limitation, any <br />tax qualified or nonqualified pension, profit sharing, stock bonus, employee savings and <br />other retirement plan, individual retirement account, deferred compensation plan and any <br />other type of employee benefit plan); select and change payment options for the principal <br />under any retirement plan; make rollover contributions from any retirement plan to other <br />retirement pla.ns or individual retirement accounts; exercise all investment powers <br />available under any type of self-directed retirement plan; and, in general, exercise all <br />powers with respect to retirement plans and retirement plan account balances which the <br />principal could if present and under no disability. <br />[�] (Nn Taz matters. To prepare, to make elections, to execute and to file all tax, <br />social security, unemployment insurance, and informational retums required by the laws <br />of the United States, or of any state or subdivision thereo� or of any foreign government; <br />to prepare, to execute, and to file all other papers and instruments which the Agent shall <br />think to be desirable or necessary for safeguazding of ine against excess or illegal taxation <br />or against penalties imposed for claimed violation of any law or other governmental <br />regulation; and to pay, to compromise, or to contest or to apply for refunds in connection <br />with any taxes or assessments for which I am or may be liable. <br />[�](1� Gifts. To make gifts to my spouse, children and more remote descendants, <br />and parents, not to exceed in the aggregate $13,000 to each of such persons in any year. <br />5PECIAL INSTRUCTIONS: ON THE FOLLOWING LINES YOU MAY GIVE <br />SPECIAL INSTRUCTIONS LIlVIlTING OR EXTENDING 'TI-� POWERS GRANTED <br />TO YOUR AGENT. <br />Page 4 of 6 � � � <br />Legal and Business Forms by Legal Helpmate Corp. - www.legalhelpmate.com <br />