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GENERAL POWER OF ATTORNEY WITH DURABLE PROVISION AND
INCLUDING MEDICAL OR OTHER HEALTH CARE DECISIONS.
000407
THIS DURABLE POWER OF ATTORNEY FOR FINANCIAL MANAGEMENT AND MEDICAL AND HEALTH CARE
DECISIONS IS GIVEN BY ME, GARRY LOUIS MORI, PRESENTLY OF 1623 ANTELOPE CT., KEMMERER, IN
THE STATE OF WYOMING, ON THE 12th DAY OF NOVEMBER 2007.
THIS IS A DURABLE POWER OF ATTORNEY AND MEDICAL OR OTHER HEALTH CARE DECISIONS
DOCUMENT AUTHORIZING THE FOLLOWING ATTORNEYS-IN-FACT TO HAVE ALL POWER TO MAKE ALL
FINANCIAL AND MEDICAL DECISIONS FOR ME IF I BECOME DISABLED OR INCAPACITATED.
I APPOINTTHE FOLLOWING TO ACT EITHER INDIVIDUALLY OR TOGETHER FOR MY BENEFIT:
1. Sharon L. Mon, my wife.
1623 Antelope Ct.
Kemmerer, Wyoming 83101
2. Tisha L. Colvin, my step-daughter.
8870 Trayls Ridge
Pocatel1o, Idaho 83201
RECEIVED 11/13/2007 at 10:50 AM
RECEIVING # 934768
BOOK: 678 PAGE: 407
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
3. Bryan C. Nicholson, my step-son.
14198 Friendship Drive
Herrman, Utah 84096
THIS POW~R OF AT! EY SH L BECOME EFFECTIVE IMMEDIATELY.
I
Date: II" (,.. UJt'J1
Novembe~ 2007
13
State of ! \AII,11JhïiY\5
County of J- n (0 I h
I, .:3øc.v A, We.rneY , Notary Public in and for the State of WYD1I1iY'lJ
do heréby:certlfy that on this ~-t:b day of tJ1)vcrn.bcr, 1/DD7 , personally appeared before
me . M
gaÞfj LvulS Dyj to be known to be the individual described in and who executed the within
instrument and acknowledged that she signed the same as her free and voluntary act and deed for the
uses and purposes herein mentioned.
Signed and sworn to before me this æday of N
Notary bllc in and for the State of vJYO~ìhj
My app intment
expires: .1ð/Jq'~OIl
! Stacy A. Werner - Notary Public
County of Slale of
Uncoln Wyoming
11/12/2007