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Home My WebLink About89515204018595 895152. RECEIVED 'L. iNOOLN COUNTY CLERK 03NOV-7 PH O AN.F,[E WAGNER A205-10 GENERAL POWER OF ATTORNEY R205-04 (With Durable Provision) NOTICE: THIS IS AN IMPORTANT DOCUMENT. BEFORE SIGNING THIS DOCU- MENT, 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 PERSON- AL PROPERTY WITHOUT ADVANCE NOTICE TO YOU OR APPROVAL BY YOU. YOU MAY SPECIFY THAT THESE POWERS WILL EXIST EVEN AFTER YOU BECOME DIS- ABLED, INCAPACITATED OR INCOMPETENT. THIS DOCUMENT DOES NOT AUTHORIZE ANYONE TO MAKE MEDIC&L OR OTHER HEALTH CARE DECISIONS FOR YOU; IF THERE IS ANYTHING ABOUT THIS FORM THAT YOU DO NOT UNDER- STAND, 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, f% tci ' the undersigned Grantor, do hereby make and grant a general power of attorney to ~- t%'o'A ~~?"¢9"- ' and do thereupon constitute and appoint said individual as my attorney-in-fact, My attorney-in-fact shall act in my nam. e, plac~ and stead in any way Which I mysei? c0Uld ~o,-~;-I- were per- sonally present, with respect to the following matters, to tile extent that I am permitted by law to act through an agent: (NOTICE: The grantor must write his or her initials in the corresponding blank space of a box below with respect to each of the subdivisions (A) through (O) below for which the Grantor wants to give the agent authority. If the blank space within a box for any particular subdivision is NOT initialed, NO AUTHORITY WILL BE GRANTED for mat- ters t~cluded in that subdivision. Cross out each power withheld.) [ 6~dt:~'''] (A) Real estate transactions [ ~ 13r ] (B) Tangible personal property transactions [ ~0- ] (C) Bond, share and commodity transactions [ {~ ~ ] (D) Banking transactions [t¢~] (E) Business operating transactions [ ] (F) Insurance transactions [ '{t~/' ] (G) Gifts to charities and individuals other than Attorney-in-Fact (If trust distributions are involved or tax consequences are anticipated, consult an attorney.) [ ~-'A- ] (n) Personal mlat~o~hips"an~{ affa~,'.:,~,' I OV'~' ] (K) Records. reports and statements AZHF {Revised 2/97) 0 E-Z Legal Forms. Before you use this form, read il, fill in all blnnks, and mnkc whalever changes nrc necessnry to your particulnr a'ansaction. Consult a lawyer if you doubt thc form's fitness for your purpose and use. E-Z Legal Forms and Ibc retailer nmke no rcpresentalion or warranty, express or implied, with respect to the merchantability of this form for an intended use or purpose. [ ~ ] (L) Full and unqualified authority to my attorney-in-fact to delegate any or all of the foregoing powers to any person or persons whom my attorney-in-fact shall select [ ~)~0A ] (M) Access to safe deposit box(es) [ ~tvA ] (N) AH other matters Durable Provision: [ ~'~ ] (0) If the blank space in the block to the left is initialed by the Grantor, this power of attor- ney shall not be affected by the subsequent disability or incompetence of the Grantor. Other Terms: My attomey-in-fact hereby accepts this appointment subject to its terms and agrees to act and perform in said fiduciary capacity consistent with my best interests as 'he/she in his/her best dis- cretion deems advisable, and I affirm and ratify all acts so undertaken. TO INDUCE ANY THIRD PARTY TO ACT HEREUNDER, I HEREBY AGREE THAT ANY THIRD PARTY RECEIVING A DULY EXECUTED COPY OR FACSIMILE OF THIS INSTRUMENT MAY ACT HEREUNDER, AND THAT REVOCATION OR TERMINATION HEREOF SHALL BE INEFFECTIVE AS TO SUCH THIRD PARTY UNLESS AND UNTIL ACTUAL NOTICE OR KNOWLEDGE OF SUCH REVOCATION OR TERMINATION SHALL HAVE BEEN RECEIVED BY SUCH THIRD PARTY, AND I FOR MYSELF AND FOR MY HEIRS, EXECUTORS, LEGAL REPRESENTATIVES AND ASSIGNS, HEREBY AGREE TO INDEMNIFY AND HOLD HARMLESS ANY SUCH THIRD PARTY FROM AND AGAINST ANY AND ALL CLAIMS THAT MAY ARISE AGAINST SUCH THIRD PARTY BY REASON OF SUCH THIRD PARTY HAVING RELIED ON THE PROVISIONS OF THIS INSTRUMENT Signed Under seal this dayof Witness Grantor Witness State of County of o. '-t, Attorney-in-Fact bef°rg, me., r'¢~m ~. ~[G,0 ,~ , appe~ed ~ ~ CP~O~%l~ , persbnally 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 capaci- ty(ies), and ti]at 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 ~~~f~cial seal. (Seal) My Oommluslo~ E~ 7-28.~ - Affiant L'/Known L~Profluced ID Type of ID IO~lO~l fflcA If your state requires 8 '/2" x 11" forms, cut off the bottom of this page at the dotted line.