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INDIANA

DURABLE

POWER OF

TORNEY

THE POWERS YOU GRANT BELOW ARE EFFECTIVE EVEN IF YOU BECOME

DISABLED

INCOMPETENT

NOTICE: THE POWERS GRANTED BY THIS DOCUMENT ARE BROAD AND

SWEEPING. THEY ARE EXPLAINED IN THE UNIFORM STATUTORY FORM

POWER OF ATTORNEY ACT. IF YOU HAVE ANY QUESTIONS ABOUT

THESE POWERS, OBTAIN COMPETENT LEGAL ADVICE. THIS DOCUMENT

DOES NOT AUTHORIZE ANYONE TO MAKE MEDICAL OR OTHER

HEALTH-CARE DECISIONS FOR YOU. YOU MAY REVOKE THIS POWER

OF ATTORNEY IF YOU LATER WISH TO DO

SO.

I [Principal’s Name] of

[Principal’s Address] appoint [Agent’s Name] of

[Agent’s Address] as my Agent

(attorne

-in-

fact)

to act for me in any lawful way with respect to the following initialed

subjects:

TO GRANT ALL OF THE FOLLOWING POWERS, INITIAL THE LINE IN FRONT

OF (N) AND IGNORE THE LINES IN FRONT OF THE OTHER

POWERS.

TO GRANT ONE OR MORE, BUT FEWER THAN ALL, OF THE FOLLOWING

POWERS, INITIAL THE LINE IN FRONT OF EACH POWER YOU ARE

GRANTING.

TO WITHHOLD A POWER, DO NOT INITIAL THE LINE IN FRONT OF IT. YOU

MAY, BUT NEED NOT, CROSS OUT EACH POWER

WITHHELD.

Note: If you

initial

Item A or Item B,

which follow,

notarized

ignature

will be

required

on behalf of the

Principal.

INITI

(A) Real

property transactions.

To lease, sell, mortgage, purchase,

exchange, and acquire, and to agree, bargain, and contract for the lease, sale,

purchase, exchange, and acquisition of, and to accept, take, receive, and

possess any interest in real property whatsoever, on such terms and conditions,

and under such covenants, as my Agent shall deem proper; and to maintain,

repair, tear down, alter, rebuild, improve manage, insure, move, rent, lease, sell,

convey, subject to liens, mortgages, and security deeds, and in any way or

manner deal with all or any part of any interest in real property whatsoever,

including specifically, but without limitation, real property lying and being

situated in the State of Indiana, under such terms and conditions, and

under such covenants, as my Agent shall deem proper and may for all deferred

payments accept purchase money notes payable to me and secured by

mortgages or deeds to secure debt, and may from time to time collect and

cancel any of said notes, mortgages, security interests, or deeds to secure

debt.

(B)

Tangible personal property transactions.

To lease, sell,

mortgage, purchase, exchange, and acquire, and to agree, bargain, and

contract for the lease, sale, purchase, exchange, and acquisition of, and to

accept, take, receive, and possess any personal property whatsoever, tangible

or intangible, or interest thereto, on such terms and conditions, and under such

covenants, as my Agent shall deem proper; and to maintain, repair, improve,

manage, insure, rent, lease, sell, convey, subject to liens or mortgages, or to

take any other security interests in said property which are recognized under

the Uniform Commercial Code as adopted at that time under the laws of the

State of Indiana or any applicable state, or otherwise hypothecate (pledge),

and in any way or manner deal with all or any part of any real or personal

property whatsoever, tangible or intangible, or any interest therein, that

own

at the time of execution or may thereafter acquire, under such terms and

conditions, and under such covenants, as my Agent shall deem

proper.

transactions.

To purchase, sell, exchange,

surrender, assign, redeem, vote at any meeting, or otherwise transfer any

and all shares of stock, bonds, or other securities in any business,

association, corporation, partnership, or other legal entity, whether private or

public, now or hereafter belonging to

me.

(D)

Commodity

and option

transactions.

To buy, sell, exchange,

assign, convey, settle and exercise commodities futures contracts and call

and put options on stocks and stock indices traded on a regulated options

exchange and collect and receipt for all proceeds of any such transactions;

establish or continue option accounts for the principal with any securities

futures broker; and, in general, exercise all powers with respect to

commodities and options which the principal could if present and under no

disabilit

(E) Banking and other

financial institution transactions.

make, receive, sign, endorse, execute, acknowledge, deliver and possess

checks, drafts, bills of exchange, letters of credit, notes, stock certificates,

withdrawal receipts and deposit instruments relating to accounts or deposits

in, or certificates of deposit of banks, savings and loans, credit unions, or

other

institutions or associations. To pay all sums of money, at any time or times,

that may hereafter be owing by me upon any account, bill of exchange, check,

draft, purchase, contract, note, or trade acceptance made, executed, endorsed,

accepted, and delivered by me or for me in my name, by my Agent.

To borrow from time to time such sums of money as my Agent may

deem

proper and execute promissory notes, security deeds or agreements, financing

statements, or other security instruments in such form as the lender may

request and renew said notes and security instruments from time to time in

whole or in part. To have free access at any time or times to any safe deposit

box or vault to which

might have

access.

(F) Business

operating transactions.

To conduct, engage in, and

otherwise transact the affairs of any and all lawful business ventures of whatever

nature or kind that I may now or hereafter be involved in. To organize or

continue and conduct any business which term includes, without limitation, any

farming, manufacturing, service, mining, retailing or other type of

business

operation in any form, whether as a proprietorship, joint venture, partnership,

corporation, trust or other legal entity; operate, buy, sell, expand, contract,

terminate or liquidate any business; direct, control, supervise, manage or

participate in the operation of any business and engage, compensate and

discharge business managers, employees, agents, attorneys, accountants

and

consultants; and, in general, exercise all powers with respect to business

interests and operations which the principal could if present and under no

disability.

(G) Insurance and annuity

transactions.

To exercise or perform any

act, power, duty, right, or obligation, in regard to any contract of life, accident,

health, disability, liability, or other type of insurance or any combination of

insurance; and to procure new or additional contracts of insurance for me and to

designate the beneficiary of same; provided, however, that my Agent cannot

designate himself or herself as beneficiary of any such insurance

ontract

(H) Estate, trust, and other

beneficiary transactions.

To accept, receipt

for, exercise, release, reject, renounce, assign, disclaim, demand, sue for, claim

and recover any legacy, bequest, devise, gift or other property interest or

payment due or payable to or for the principal; assert any interest in and

exercise any power over any trust, estate or property subject to

fiduciar

control; establish a revocable trust solely for the benefit of the principal that

terminates at the death of the principal and is then distributable to the legal

representative of the estate of the principal; and, in general, exercise all powers

with respect to estates and trusts which the principal could exercise if present

and under no disability; provided, however, that the Agent may not make or

change a will and may not revoke or amend a trust revocable or amendable by

the principal or require the trustee of any trust for the benefit of the principal to

pay income or principal to the Agent unless specific authority to that end is

given.

(I)

Claims and

litigation.

To commence, prosecute, discontinue, or

defend all actions or other legal proceedings touching my property, real or

personal, or any part thereof, or touching any matter in which

or, my

property, real or personal, may be in any way concerned. To defend, settle,

adjust, make allowances, compound, submit to arbitration, and compromise all

accounts, reckonings, claims, and demands whatsoever that now are, or

hereafter shall be, pending between me and any person, firm, corporation, or

other legal entity, in such manner and in all respects as my Agent shall deem

proper.

(J) Personal and family maintenance. To hire accountants,

attorneys at law, consultants, clerks, physicians, nurses, agents, servants,

workmen, and others and to remove them, and to appoint others in their

place, and to pay and allow the persons so employed such salaries, wages,

or other remunerations, as my Agent shall deem

proper.

(K) Benefits from Social Security, Medicare, Medicaid, or

ernmental

programs,

military

service. To prepare, sign and file any

claim or application for Social Security, unemployment or military service

benefits; sue for, settle or abandon any claims to any benefit or assistance

under any federal, state, local or foreign statute or regulation; control, deposit

to any account, collect, receipt for, and take title to and hold all benefits under

any Social Security, unemployment, military service or other state, federal,

local or foreign statute or regulation; and, in general, exercise all powers with

respect to Social Security, unemployment, military service, and governmental

benefits, including but not limited to Medicare and Medicaid, which the

principal could exercise if present and under no

disability.

(L) Retirement plan

transactions.

To contribute to, withdraw from

and deposit funds in any type of retirement plan (which term includes, without

limitation, any tax qualified or nonqualified pension, profit sharing, stock

bonus, employee savings and other retirement plan, individual retirement

account, deferred compensation plan and any other type of employee benefit

plan); select and change payment options for the principal under any

retirement plan; make rollover contributions from any retirement plan to other

retirement plans or individual retirement accounts; exercise all investment

powers available under any type of self-directed retirement plan; and, in

general, exercise all powers with respect to retirement plans and retirement

plan account balances which the principal could if present and under no

disability.

(M) Tax matters. To prepare, to make elections, to execute and to file

all tax, social security, unemployment insurance, and informational returns

required by the laws of the United States, or of any state or subdivision thereof,

or of any foreign government; to prepare, to execute, and to file all other

papers and instruments which the Agent shall think to be desirable

necessary for safeguarding of me against excess or illegal taxation or against

penalties imposed for claimed violation of any law or other governmental

regulation; and to pay, to compromise, or to contest or to apply for refunds in

connection with any taxes or assessments for which I am or may be

liable.

(N) ALL OF THE POWERS LISTED ABOVE. YOU NEED NOT

INITIAL ANY OTHER LINES IF YOU INITIAL LINE

(N).

SPECIAL

INSTRUCTIONS

ON THE FOLLOWING LINE YOU MAY GIVE SPECIAL

INSTRUCTIONS LIMITING OR EXTENDING THE POWERS GRANTED

TO YOUR

AGENT.

THIS POWER OF ATTORNEY IS EFFECTIVE IMMEDIATELY AND WILL

CONTINUE UNTIL IT IS

REVOKED.

THIS POWER OF ATTORNEY SHALL BE CONSTRUED AS A GENERAL

DURABLE POWER OF ATTORNEY AND SHALL CONTINUE TO BE EFFECTIVE

EVEN IF

BECOME DISABLED, INCAPACITATED, OR

INCOMPETENT.

(YOUR AGENT WILL HAVE AUTHORITY TO EMPLOY OTHER PERSONS AS

NECESSARY TO ENABLE THE AGENT TO PROPERLY EXERCISE THE

POWERS GRANTED IN THIS FORM, BUT YOUR AGENT WILL HAVE TO MAKE

ALL DISCRETIONARY DECISIONS. IF YOU WANT TO GIVE YOUR AGENT

THE RIGHT TO DELEGATE DISCRETIONARY DECISION-MAKING POWERS

TO OTHERS, YOU SHOULD KEEP THE NEXT SENTENCE, OTHERWISE IT

SHOULD BE

STRICKEN.)

Authority

to Delegate. My Agent shall have the right by written instrument to

delegate any or all of the foregoing powers involving discretionary

decision-

making to any person or persons whom my Agent may select, but such

delegation may be amended or revoked by any agent (including any successor)

named by me who is acting under this power of attorney at the time of

reference.

(YOUR AGENT WILL BE ENTITLED TO

REIMBURSEMENT

FOR ALL

REASONABLE

EXPENSES INCURRED IN ACTING UNDER THIS POWER OF

ATTORNEY. STRIKE OUT THE NEXT SENTENCE IF YOU DO NOT WANT

YOUR AGENT TO ALSO BE ENTITLED TO REASONABLE

COMPENSATION

FOR SERVICES AS

AGENT.)

Right to

Compensation.

My Agent shall be entitled to reasonable

compensation for services rendered as agent under this power of

attorney.

(IF YOU WISH TO NAME SUCCESSOR AGENTS, INSERT THE NAME(S)

AND

ADDRESS(ES)

OF SUCH SUCCESSOR(S) IN THE FOLLOWING

PARAGRAPH.)

Successor Agent. If any Agent named by me shall die, become incompetent,

resign or refuse to accept the office of Agent, I name the following (each to act

alone and successively, in the order named) as successor(s) to such

Agent:

Choice of Law. THIS POWER OF ATTORNEY WILL BE GOVERNED BY

THE LAWS OF THE STATE OF INDIANA WITHOUT REGARD FOR

CONFLICTS OF LAWS PRINCIPLES. IT WAS EXECUTED IN THE STATE

OF INDIANA AND IS INTENDED TO BE VALID IN ALL JURISDICTIONS OF

THE UNITED STATES OF AMERICA AND ALL FOREIGN

NATIONS.

am fully informed as to all the contents of this form and understand the full

import of this grant of powers to my

Agent.

agree that any third party who receives a copy of this document may act

under it. Revocation of the power of attorney is not effective as to a third

party until the third party learns of the revocation. I agree to indemnify the

third party for any claims that arise against the third party because of

reliance on this power of

attorne

Signed this day of ,

[Signature of

Principal]

[Signature of

Agent]

[Signature of Successor Agent (if

any)]

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Notary Acknowledgement (Must be completed by Notary)

State of County of Subscribed,

Sworn and acknowledged before me by , the

Principal, and subscribed and sworn to before me by ,

witness, this day of .

Notary Signature

Notary Public

In and for the County of

State of

My commission expires:

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