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HomeMy WebLinkAbout887419881 19 BOOK U~J__~. PR PAGE 6 9 ~) RECEIVED LINCOL!'4 CO_tNTY CLERK LF240-04 R240-04 LIMITED POWER OF ATTORNEY (With Durable Provision) NOTICE: THIS IS AN IMPORTANT DOCUMENT. BEFORE SIGNING THIS DOCUMENT, YOU SHOULD KNOW THESE IMPORTANT FACTS. THE PURPOSE OF THIS POWER OF ATTORNEY IS TO GIVE THE PERSON WHOM YOU DESIGNATE (YOUR "AGENT") BROAD POWERS TO HANDLE YOUR PROPERTY, WHICH MAY INCLUDE POWERS TO PLEDGE, SELL OR OTHERWISE DISPOSE OF ANY REAL OR PERSONAL PROPERTY WITHOUT ADVANCE NOTICE TO YOU OR APPROVAL BY YOU. YOU MAY SPECIFY THAT THESE POWERS WILL EXIST EVEN AFTER YOU BECOME DISABLED, INCAPACITATED OR INCOMPETENT. THIS DOCUMENT DOES NOT AUTHORIZE ANYONE TO MAKE MEDICAL OR OTHER HEALTH CARE DECISIONS FOR YOU. IF THERE IS ANYTHING ABOUT THIS FORM THAT YOU DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER TO EXPLAIN IT TO YOU. YOU MAY REVOKE THIS POWER OF ATTORNEY IF YOU LATER WISH TO DO SO. TO ALL PERSONS, be it known, that I, i',d cz cS c v,, ~(bP(~i I / 0~ as Grantor, do hereby make' and ~¢ant a lir~ited an~ specific power of attorney to 3"eA ~c~OPgi / \ o~ n ' and appoint and constitute said individual as my attorney-in-fact. My named attorney-in-fact shall have full power and authority to undertake, commit and perform only the following acts on my behalf to the same extent as if I had done so personally; all with full power of substitution and revocation in the presence: (Describe specific authority) The authority granted shall include such incidental acts as are reasonably required or necessary to carry out and perform the specific authorities and duties statedor contemplated herein. My attorney-in-fact agrees to accept this appointment subject to its terms, and agrees to act and perform in said fiduciary capacity consistent with my best interests as my attorney-in-fact deems advisable, and I thereupon ratify all acts so carded out. I agree to reimburse my attorney-in-fact all reasonable costs and expenses incurred in the fulfillment of the duties and responsibilities enumerated herein. IMPORTANT NOTE: This form is not valid for delegating personal financial and or property matters in the state of M,a, ine] To obtain the cor_~r. Lfo~Tcalt-ll_800_822_4566 or visit vm;w. MadeE-Z.com and click acc~ss~,h'o!f"'~'f6'~iii'~for a re'~d'" ,~'"'":.~,.q~ .,. ......~..,,..".O:~}oadableform. © 1992-2001 Made E-Z Products lnc This product does not constitut ' ' ' · . r~;~ ?.Y8~ ~,eW M~£; c'.'[ :¢~';?:~JJ' ~;. Rev 031 etherendenngoflegaladvmeorserv es.l~f§~rod t'~i for .... ::.,~ ~.~ ~ . 02 advice. State laws var~ so consult a · :~o~!~ t~, ~ Bt~d~g~ mfi ..~t~n~gn! nd ~s not a subsutme for le al ~ ~' ~x:~ ~u,e.z:~'~''~ *,-~s~ -~xy~m.~.?~ff)~ns~ ~o pracnce law m your state. ~ t~ - ' ~ ': '...t'2 ~: ......... AFAB 697 Special durable provisions: This power of attorney shall not be affected by subsequent incapacity of the Grantor. This power of attorney may be revoked by the Grantor giving written notice of revocation to the attorney-in-fact, provided that any party relying in good faith upon this power of attorney shall be protected unless and until said party has either a) actual or constructive notice of revocation, or b) upon recording of said revocation in the public records where the Grantor resides. Other terms: under seal this /"qOadO,~J\ day of Signed Signed in the presence of: WitnesS- V At~'ome~,-in-Fact Witness Witness State of County of } On before me, ' appeared personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature ~,;¢cdv~ Affiant Type of ID Known Produced ID (Seal) State of [/t/7/a A County of Pb/~ ~ , } ,-. ........ ,~ :zv~.--, before me, ~ 0 ~ ~ ~ ~-- ~' ~~ ' ~rsen~lN k~ew~ to me (or proved to me on the basis of satishcto~ evidence) to be the person~) whose nmeq)~e~~ a~-Subscribed to the wit~ ~stmme~t and ac~owledged to me ~at h~hey executed ~e sine ~n h~the~ a 'zed capaci~ ' d that by hs~ek signamre(~. ~.- on the ins~ment the person~), or ~~'al~~Pers°n~ acted, executed the instrument. Signat~ ~~~ own ~ produced m~ ~~ T~e of ID ~ D~I v~ CtC~ , (Seal)