Statutory Form For Power Of Attorney Page 2

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____________ (H) Estate, trust, and other beneficiary transactions.
____________ (I) Claims and litigation.
____________ (J) Personal and family maintenance.
____________ (K) Benefits from Social Security, Medicare, Medicaid, or other governmental
programs, or military service.
____________ (L) Retirement plan transactions.
____________ (M) Tax matters.
____________ (N) ALL OF THE POWERS LISTED ABOVE. YOU NEED NOT INITIAL
ANY OTHER LINES IF YOU INITIAL LINE (N).
SPECIAL INSTRUCTIONS:
ON THE FOLLOWING LINES YOU MAY GIVE SPECIAL INSTRUCTIONS LIMITING OR
EXTENDING THE POWERS GRANTED TO YOUR AGENT.
______________________________________________________________________________
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(Attach additional pages if needed.)
UNLESS YOU DIRECT OTHERWISE ABOVE, THIS POWER OF ATTORNEY IS
EFFECTIVE IMMEDIATELY AND WILL CONTINUE UNTIL IT IS REVOKED.
This power of attorney will continue to be effective even though I become disabled,
incapacitated, or incompetent.
STATUTORY FORM FOR POWER OF ATTORNEY
Page 2

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