1587 Fisherville VetExempt Docs-JTackebury.pdf

Jack C Tackebury Petitioner V Township Of Williams Respondent · 26-002269-TT

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Michigan Department of Treasury 

6055 (Rev. 11-24) 

Notice of Denial of Disabled Veterans Exemption 

Issued under authority of Public Act 206 of 1893, as amended 

With this notice, you are notified that the Disabled Veterans Exemption on the property identified below has been 

denied. If you have questions about the denial, you may contact your local government or follow the appeal procedures 

specified below. 

Type or print in blue or black ink. 

PART 1: PROPERTY INFORMATION Type or print legibly. Use a separate form for each property number. 

1. Property Tax Identification Number 

2. Name of Local Unit (Check Township or City) 

140-F07-000-025-00 

Williams Charter Township 

3. County 

Bay 

Township 

[city 

4. Street Address of Property (Provide a Complete Address) 

City 

State 

ZIP Code 

1587 Fisherville Ct. 

Auburn 

MI 

48611 

5. Name of Owner (First, Middle, Last) 

Jack Charles Tackebury 

6. Owner's Daytime Telephone Number 

7. Owner's Email Address 

(989) 450-9432 

8. Mailing Address if Different than Property Address 

City 

State 

ZIP Code 

9. Your exemption was denied/adjusted for the following reason: 

a. The owner is neither a disabled veteran who qualifies for the exemption nor the unremarried surviving spouse of 

a disabled veteran who, immediately before death, was eligible for the exemption 

OJ b. The property claimed is not the owner's homestead. 

O c./ The property has transferred, and the qualifying individual is no longer the owner. 

O d. The person claiming the exemption is not the owner. 

[J e. other: 

10, Sioa Denied for Calendar Year(s) or Partial Calendar Year: 

PART 2: CERTIFICATION 

11. Name of the Local Assessor (Print or Type) 

Tod Fackler 

13. Date 

05/07/2026 

72. Mle 

ZL ‘ 

State 

Mi 

ZIP Code 

48611 

14. Address of Local Government Unit 

1080 W. Midland Rd. 

City 

Auburn 

15. Telephone Number of Local Government Unit 

(989) 662-4241 ext. 14 

16. Email Address of Assessor 

assessor@uwilliamstwpmi.gov 

I 

HOMEOWNER'S RIGHT TO APPEAL 

Tax Tribunal at PO Box 30232, Lansing, 

by the Michigan Tax Tribunal. 

within 35 days of the denial. An appeal with the Michi 

The petition must be a Michigan Tax Tribunal form or 

Tribunal forms are available at www.michi 

If you disagree with this denial, you may appeal to the Residential/Small Claims Division of the Michigan Tax Tribunal 

gan Tax Tribunal can be initiated by the timely filing of a petition. 

a form approved by the Michigan Tax Tribunal. Michigan Tax 

gan.govitaxtrib. You can print and mail the completed form to the Michigan 

MI 48909, or complete the form online and submit electronically, if provided for

6055, Page 2 

Instructions for Form 6055 

Notice of Denial of Disabled Veterans Exemption 

General Instructions 

This form is for local assessors to use when notifying 

a homeowner that his or her disabled veterans exemption is denied. 

It will also be used to notify the Department of Treasury of the denial. Complete all information carefully and accurately to 

avoid processing errors. 

Mail the original to the homeowner. Appeal rights are printed on the bottom of the form. The assessor must retain a copy 

for the assessor's records. 

Line-by-Line Instructions 

Lines not listed here are explained on the form. 

PART 1: PROPERTY INFORMATION 

Line 1: You must complete this line. Do not enter more than one property identification number (PIN) on each form. The 

PIN should be identical to the number used on the original affidavit. 

Lines 2-4: Enter the complete address. Enter name and check the appropriate box for the city or township in which the 

principal residence is located. 

Lines 5-7: Enter the name and contact information of the legal owner(s) that occupy the property. 

Line 8: Enter the mailing address if it is different from the address on line 4. 

Line 9: Check the box indicating the reason the disabled veterans exemption was denied. If none apply, check “other” and 

enter a more detailed explanation of your reasons for denial. Be specific and as complete as possible. The information 

you provide in this section may be used in the appeals process. 

For the purposes of the exemption, MCL 211.7b defines “Disabled Veteran” as a veteran who is a resident of this state 

and who meets one (1) of the following criteria and can provide documentation to that effect: 

1. Has been determined by the United States Department of Veterans Affairs to be permanently and totally disabled 

as a result of military service and entitled to veterans’ benefits at the 100% rate. 

2. Has a certificate from the United States Department of Veterans Affairs certifying that the veteran is receiving or 

has received pecuniary assistance due to disability for specially adapted housing. 

3. Has been rated by the United States Department of Veterans Affairs as individually unemployable. 

Line 10: Enter all years or partial year that are being denied. (You have the authority to deny the current year and the 

three preceding years.) 

PART 2: CERTIFICATION 

Line 11: This form must be signed by the local assessor. Indicate who is denying the exemption. 

Line 13: The homeowner has only 35 days to appeal an exemption denial. The date you enter here is the starting date for 

the homeowner's appeal time. Mail all forms the day they are signed. 

Lines 14-15: Enter the address and telephone number of the proper contact person at the local government. 

Additional Forms or Questions? 

This form is available on Treasury's website at www.michigan.gov/statetaxcommission.

Michigan Department of Treasury 

5107 (Rev. 11-24) 

State Tax Commission Affidavit for Disabled Veterans Exemption 

Issued under authority of Public Act 161 of 2013, MCL 211.7b. Filing is mandatory. 

Instructions: This form is to be used to apply for an exemption of property taxes under 211.7b and 211.7, for real property used and owned as 

a homestead by a disabled veteran or an unremarried surviving spouse of a disabled veteran who, immediately before death, was eligible for the 

exemption under this section. Submit the completed form with required documentation to the local assessor in the city or township where the 

property is located. 

OWNER INFORMATION (Enter information for the disabled veteran or unremarried surviving spouse) 

Owner's Name 

Owner's Telephone Number 

JACK CHARLES TACKEBURY 

(989) 450-9432 

Owner's Mailing Address 

City 

State 

ZIP Code 

P.O. BOX 10 

AUBURN 

Mi 

48611 

LEGAL DESIGNEE INFORMATION (Complete if applicable) 

Legal Designee Name 

Daytime Telephone Number 

Legal Designee Mailing Address 

City 

State 

ZIP Code 

HOMESTEAD PROPERTY INFORMATION (Enter information for the property in which the exemption is being claimed) 

Name of Local Unit (Check Township, City or Village) 

County 

WILLIAMS 

BAY 

[] city 

Lr 

] Village 

BA v the Local School District 

Parcel Identification Number 

Date the Property was Acquired (MM/DD/YYYY) 

140-F07-000-025-00 

07/28/2025 

. 

Homestead Property Address 

City 

State 

ZIP Code 

1587 FISHERVILLE COURT 

AUBURN 

Mi 

48611 

ACKNOWLEDGEMENT (Check all boxes that apply) 

I'am a disabled veteran, or the legal designee of the disabled veteran. 

as] 

| am an unremarried surviving spouse of a disabled veteran who, immediately before death, was eligible for the exemption 

under this section. 

| am a Michigan resident. 

| own the property in which the exemption is being claimed and it is used as my homestead. Homestead is generally defined as 

any dwelling with its land and buildings where a family makes its home. 

AFFIRMATION OF ELIGIBILITY (Check the appropriate box and provide a copy of the required documentation) 

The disabled veteran has been determined by the United States Department of Veterans Affairs to be permanently and totally 

disabled as a result of military service and entitled to veterans’ benefits at the 100% rate (must attach a copy of the letter from 

the U.S. Department of Veterans Affairs). 

J The disabled veteran is receiving or has received pecuniary assistance due to disability for specially adapted housing (must 

attach a copy of the certificate from the U.S. Department of Veterans Affairs). 

The veteran has been rated by the United States Department of Veterans Affairs as individually unemployable (must attach a 

copy of the letter from the U.S. Department of Veterans Affairs). 

CERTIFICATION 

| hereby certify to the best of my knowledge that the information provided in this Affidavit is true and 

| am eligible to receive the 

disabled veteran's exemption from property taxes pursuant to Michigan Compiled Law, Section 211.7b. 

Printed Name of Owner or Legal Designee 

Title of Signatory 

JACK CHARLES TACKEBURY 

OWNER 

Signature of Own: er or Legal, 

Designee (Design 

ust attach a letter of authority) 

Date 

{ 

Col, 

Tove 

324-203 

. 

Li 

LOCAL GOVERNMENT USE ONLY (Do not write below t 

Did the Assessor Approve or Deny the Ho 

[ll Approved 

Denied (Attach a copy of the Local Unit Denial) 

Certification: 

| certify that, to the best of my knowledge, the information contained in this form is complete and accurate. 

Assessor's Signature 

Date Certified by Assessor (MM/DD/YYYY) 

his line) 

Year the Affidavit will be posted to the tax roll

5107, Page 2 

Instructions for Form 5107 

State Tax Commission Affidavit for Disabled Veterans Exemption 

General Instructions 

This form is for local eligible taxpayers to claim the disabled veterans exemption. Complete all information carefully and 

accurately to avoid processing errors. Under MCL 211.7¢, beginning January 1, 2025, the exemption, once granted, 

remains in effect without subsequent annual reapplication by the disabled veteran or unremarried surviving spouse. The 

exemption continues until rescinded by the property owner or denied by the assessor. Form 6054, “Request to Rescind 

Disabled Veterans Exemption,” should be used to rescind the exemption. 

Line-by-Line Instructions 

Lines not listed here are explained on the form. 

Owner Information 

Provide the owner name, telephone number, and mailing address. If the affidavit is being filed by a legal designee, in 

addition to the owner information, provide the designee’s name, telephone, and mailing address. 

Homestead Property Information 

Provide the name of the city, township, or village in which the property is located (not the mailing address) as well as the 

county and school district. The parcel identification number is the real parcel number assigned to the property on which 

the disabled veterans exemption is to be claimed. The homestead property address is the street address of the property 

on which the disabled veterans exemption is to be claimed. 

Acknowledgement 

To qualify for the disabled veterans exemption, the claimant must either be a disabled veteran or the unremarried 

surviving spouse of a disabled veteran. The property on which the exemption is claimed must serve as the homestead of 

the claimant. 

For the purposes of the exemption, MCL 211.7b defines “Disabled Veteran” as a veteran who is a resident of this state 

and who meets one of the following criteria and can provide documentation to that effect: 

1. Has been determined by the United States Department of Veterans Affairs to be permanently and totally disabled 

as a result of military service and entitled to veterans’ benefits at the 100% rate. 

2. Has a certificate from the United States Department of Veterans Affairs certifying that the veteran is receiving or 

has received pecuniary assistance due to disability for specially adapted housing. 

3. Has been rated by the United States Department of Veterans Affairs as individually unemployable.

DEPARTMENT OF VETERANS AFFAIRS 

Veteran Benefits Administration 

Regional Office 

JACK TACKEBURY 

VA File 

Number 

27 234 745 

Rating Decision 

01/15/2026 

INTRODUCTION 

The records reflect that you are a Veteran of the Vietnam Era. You served in the Army from 

December 9, 1965 to December 8, 1967. We have received a copy of your recent VA 

examination dated December 1,2025. Based on a review of the evidence listed below, we have 

made the following decision(s) on your claim. 

DECISION 

Evaluation of chronic myelocytic leukemia, which is currently 100 percent disabling, is 

continued. 

EVIDENCE 

e 

VAMC (Veterans Affairs Medical Center) treatment records, received January 13, 2026 

e 

VA Examination, received December 12, 2025, conducted December 12,2025 

REASONS FOR DECISION 

uation of chronic myelocytic leukemia currently 

evaluated as 100 

percent disabling.

JACK TACKEBURY 

27234745 

20f2 

The evaluation of chronic myelocytic leukemia is continued as 100 percent disabling. 

We have assigned a 100 percent evaluation for your chronic myelocytic leukemia based on: 

* Requiring continuous immunosuppressive therapy treatment 

A 100 percent evaluation shall be assigned as of the date of hospital admission for peripheral 

; Sh or bone marrow stem cell transplant; or during the period of treatment with chemotherapy 

(including myelosuppressants). Six months following hospital discharge or, in the case of 

chemotherapy treatment, six months after completion of treatment, the appropriate disability 

rating shall be determined by mandatory VA examination. Any reduction in evaluation based 

upon that or any subsequent examination shall be subject to the provisions of § 3.105(e) of this 

chapter. 

This is the highest schedular evaluation allowed under the law for chronic myelogenous 

leukemia. (38 CFR 4.117) 

Since there is a likelihood of improvement, the assigned evaluation is not considered permanent 

and is subject to a future review examination. (38 CFR 3.327, 38 CFR 3.344) 

REFERENCES: 

Title 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans' Relief contains the 

regulations of the Department of Veterans Affairs which govern entitlement to all Veteran 

benefits. For additional information regarding applicable laws and regulations, please consult 

your focal library, or visit us at our website, WWW .vVa.gov.

MICHIGAN STATUTORY FORM 

POWER OF ATTORNEY FOR JACK C. TACKEBURY 

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IMPORTANT INFORMATION 

This power of attorney authorizes another person (your agent) to make decisions concerning 

our property for you (the Principal). It is, therefore, an important legal document, and you are 

aking a serious step if you decide to make use of this form without seeking legal advice; for if 

he person you designate as your agent accepts authority granted under this power of attorney, 

he agent will be able to make decisions and act with respect to your property (including your 

money). The extent of your agent’s authority over subjects listed on this form is explained in the 

Uniform Power of Attorney Act, MCL 556.201-.505. 

This power of attorney does not authorize the agent to make health care decisions for you, and it 

loes not authorize the agent to exercise powers you have as a parent or guardian regarding care, 

ustody, or property of a minor child or ward. 

You should select someone you trust to serve as your agent, and you should ask yourself as you 

eview each section of this form whether you have chosen the right person or people to act in that 

apacity. If your signature on this form is notarized or witnessed as provided below, then unless 

ou specify otherwise, the agent’s authority will generally continue until you die or revoke the 

ower of attorney or the agent resigns or is unable to act for you. 

our agent is entitled to reasonable compensation unless you state otherwise in the Special 

structions. 

his form provides for designation of an agent and successor agents who serve one at a time, as 

pposed to coagents who serve simultaneously. If you wish to name coagents, you may do so in 

he Special Instructions. Coagents are not required to act together unless you include that 

equirement in the Special Instructions. 

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If your agent is unable or unwilling to act for you, your power of attorney will end unless you 

have named a successor agent. You may also name a second successor agent. 

— 

his power of attorney becomes effective immediately unless you state otherwise in the Special 

nstructions. And unless you state otherwise in the Special Instructions, this power of attorney 

does not revoke any other power of attorney you may have created. 

— 

If you have questions about the power of attorney or the authority it grants to your agent, you 

hould seek legal advice before signing this form. 

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ATTORNEY FOR JACK C. 

TACKEBURY

2. 

DESIGNATION OF AGENT 

» JACK C. TACKEBURY, (Principal), name the following person as my agent: 

JACQUELINE M. BRINK 

1837 

W Midland Road 

Auburn, MI 48611 

(989) 992-9670 

3. 

DESIGNATION OF SUCCESSOR AGENTS (OPTIONAL) 

First Successor Agent: 

JENNIFER L. TACKEBURY 

1003 E. Clara. 

Bay City, MI 48706 

(989) 372-2878 

4. 

GRANT OF GENERAL AUTHORITY 

I grant my agent and any successor agent general authority to act for me with respect to the 

following subjects as defined in the Uniform Power of Attorney Act, MCL 556.201—.505: 

Initial each subject you want to include in the agent’s general authority. If you wish to grant 

general authority over all of the subjects, you may simply initial “All preceding subjects.”) 

|) Real property 

|__) Tangible personal property 

| _) Stocks and bonds 

~~ 

) Commodities and options 

— 

| __) Banks and other financial institutions 

|__) Operation of entity or business 

|) Insurance and annuities 

|) Estates, trusts, and other beneficial interests 

( 

( 

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(|) Claims and litigation 

(|__) Personal and family maintenance 

( |) Benefits from governmental programs or civil or military service 

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C. 

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) Retirement plans 

) Taxes 

7 A All preceding subjects (regardless of whether any of the preceding subjects are initialed) 

3. 

GRANT OF SPECIFIC AUTHORITY (OPTIONAL) 

My agent may not do any of the following specific acts for me unless I have initialed the specific 

authority listed below: 

CAUTION! Granting any of the following will give your agent the authority to take actions that 

gould significantly reduce your property or change how your property is distributed at your 

death. Furthermore, depending on the amount in one or more of the accounts mentioned in the 

last item listed below (which refers to 31 CFR 1010.350), granting that particular power may 

subject your agent to burdensome federal reporting obligations that are subject to stiff penalties. 

Initial only the specific authority you want to give your agent. If you have questions about the 

Wisdom of granting any specific authority to your agent, you should seek legal advice before 

signing this form. If you are inclined to grant specific authority but doubt the wisdom of granting 

that authority to a particular person you have designated as your agent or successor agent, you 

should ask yourself whether you have designated the right person or people. 

(|__) 

Create, amend, revoke, or terminate an inter vivos trust 

(I_) Make a gift as limited by section 217 of the Uniform Power of Attorney Act, MCL 

956.317, and any special instructions in this power of attorney 

(|__) Create or change rights of survivorship by, for example, creating a joint account 

|) Create or change a beneficiary designation 

|) Waive the Principal’s right to be a beneficiary of a joint and survivor annuity, including a 

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Authorize another person to exercise the authority granted under this power of attorney 

( 

. 

. 

survivor benefit under a retirement plan 

|) Exercise fiduciary powers that the Principal has authority to delegate 

) Exercise authority over any “bank, securities, or other financial account in a foreign 

( 

0 Veg Access the content of electronic communications 

( 

cpuntry” within the meaning of 31 CFR 1010.350 

6) 

LIMITATION ON AGENT’S AUTHORITY 

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ATTORNEY FOR JACK C. 

TACKEBURY

Even if I have authorized my agent to make a gift (by initialing the relevant line above), an agent 

ho is not my ancestor, spouse, or descendant MAY NOT use my property to benefit the agent 

r a person to whom the agent owes an obligation of support unless I have included that 

guthority in the Special Instructions. 

1. 

SPECIAL INSTRUCTIONS (OPTIONAL) 

You may give special instructions in this section. 

CAUTION! Special instructions are liable to cause ambiguities that may impair the effectiveness 

f this power of attorney. You are taking a solemn step if you decide to make any use of this 

form without seeking legal advice; you should be especially wary of providing special 

instructions without the benefit of legal counsel. 

§. 

EFFECTIVE DATE 

— 

his power of attorney is effective immediately unless I have stated otherwise in the Special 

Instructions. 

9. 

EFFECT ON PREVIOUS POWERS OF ATTORNEY 

Unless I have said otherwise in the Special Instructions, the execution of this power of attorney 

does not revoke any prior power of attorney. 

10. 

NOMINATION OF CONSERVATOR OR GUARDIAN (OPTIONAL) 

If 

it becomes necessary for a court to appoint a conservator or guardian of my estate or guardian 

of my person, I nominate the following person or people for appointment: 

Name of nominee for Conservator or Guardian of My Estate: 

JACQUELINE M. BRINK 

1837 W Midland Road 

Auburn, MI 48611 

OR 

JENNIFER L. TACKEBURY 

1003 E. Clara. 

Bay City, MI 48706 

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’OWER OF 

ATTORNEY FOR JACK 

C. TACKEBURY

Name of nominee for Guardian of My Person: 

JACQUELINE M. BRINK 

1837 W Midland Road 

Auburn, MI 48611 

OR 

JENNIFER L. TACKEBURY 

1003 E. Clara. 

Bay City, MI 48706 

11. 

RELIANCE ON THIS POWER OF ATTORNEY 

Any person, including my agent, may rely on the validity of this power of attorney or a copy of it 

unless that person knows that the power has terminated or is invalid. 

12. 

SIGNATURE OF PRINCIPAL, SIGNATURES OF WITNESSES, AND 

ACKNOWLEDGMENT 

PAUTION! Unless you provide otherwise in the Special Instructions, this form will create a 

urable power of attorney if you sign it either before a notary public (or other individual 

uthorized to take acknowledgments) or in the presence of two witnesses neither of whom is 

esignated as your agent or successor agent, both of whom sign below (and one of whom may be 

he notary public or other individual authorized by law to take acknowledgments who also signs 

elow in their official capacity). The power’s being durable means that unless the power is 

evoked or the agent’s authority is otherwise terminated beforehand, your agent’s authority will 

ontinue during any period in which you are alive but incapacitated. If you have questions about 

he wisdom of making this power durable, you should seek legal advice before signing this form. 

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CAUTION! You have an important motivation to acknowledge your signature before a notary 

public (or other individual authorized to take acknowledgments) regardless of the question of 

ability (described above): doing so will make it harder, under section 120 of the Uniform 

ove of Attorney Act, MCL 556.220, for someone to whom the power is presented to decline to 

cept the power and your agent’s authority to act on your behalf. 

ated: January 17, 2025 

At Todt) 

/IACK C. TACKEBURA 

1224 Rainbow Drive 

West Branch, MI 48661 

— 

WER OF ATTORNEY FOR JACK 

C. 

TACKEBURY

Witness 

\ 

Dated: January 17, 2025 

a 

Matthew B. Hewitt 

Witness 

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Dated: January 17, 2025 

AML 

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Anne Pack 

STATE OF MICHIGAN 

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BAY COUNTY 

) 

Acknowledged before me in Bay 

County, Michigan, on January 17, 2025, by JACK C. 

TACKEBURY 

Matthew B. Hewitt 

Notary public, State of Michigan, County of Bay 

My commission expires 12/19/2026 

Prepared by: 

GARSKE HEWITT, PLC 

By: Matthew B. Hewitt (P57721) 

708 S. Euclid Ave. 

Bay City, MI 48706 

989) 355-0100 

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POWER OF ATTORNEY FOR JACK C. TACKEBURY

AGENT'S ACKNOWLEDGMENT 

, JACQUELINE M. BRINK, have been appointed agent for the principal JACK C. 

ACKEBURY, under a durable power of attorney dated January 17, 2025. By signing this 

Jocument, I acknowledge that if and when I act as agent under the power, all of the following 

pply: 

MY DUTIES AS AGENT 

I MUST: 

- Do what I know the principal reasonably expects me to do with the principal's property or, if I 

do not know the principal's expectations, act in the principal's best interest. 

2. Act in good faith. 

3- Do nothing beyond the authority granted in the durable power of attorney. 

4. Keep reasonable records of receipts, disbursements, and transactions I make on behalf of the 

principal. 

. 

- Disclose my identity as an agent whenever I act for the principal by writing or printing the 

principal's name and signing my own name as "agent". 

6. And depending on the terms of the power of attorney, I may have additional duties described 

in section 114 of the uniform power of attorney act, MCL 556.201 to 556.505, including the 

presumptive duties to act loyally for the principal's benefit, avoid conflicts of interest that would 

thake it hard for me to act in the principal's best interest, and act with care, competence, and 

diligence. 

POWERS REQUIRING SPECIFIC AUTHORITY 

Unless specifically provided in the durable power of attorney or by judicial order, 

I CANNOT 

0 ANY OF THE FOLLOWING: 

— 

1. Create, amend, revoke, or terminate an inter vivos trust. 

DD 

. Make a gift of the principal's property to someone else, let alone to myself. 

3. Create or change rights of survivorship by, for example, creating a joint account. 

4. Create or change a beneficiary designation. 

5. Delegate authority granted under the durable power of attorney. 

6. Exercise fiduciary powers that the principal has authority to delegate. 

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OWER 

OF ATTORNEY FOR JACK 

C. 

TACKEBURY

7. Waive the principal's right to be a beneficiary of a joint and survivor annuity, including a 

qurvivor benefit under a retirement plan. 

- Exercise authority over the content of electronic communications, as defined in 18 USC 2510, 

sent or received by the principal. 

9. Exercise authority over any bank, securities, or other financial account in a foreign country 

within the meaning of 31 CFR 1010.350. 

TERMINATION OF MY AUTHORITY 

I must stop acting on behalf of the principal if I learn of any event that terminates the durable 

power of attorney or my authority under the power, including the death of the principal or the 

principal's revocation of either the power or my authority to act under it. 

MY POTENTIAL LIABILITY AS AGENT 

If I violate the uniform power of attorney act, MCL 556.201 to 556.505, or act outside the 

quthority granted in the durable power, I may be liable to the principal or the principal's 

Successors for damages caused by my violation and to civil or criminal penalties. An exoneration 

dlause in the power (if any) does not relieve me of liability for acts or omissions committed in 

bad faith or, in some cases, for acts or omissions committed with reckless indifference to the 

purposes of the power of attorney or the interests of the principal. 

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Date: 

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f there is anything about this document or your duties that you do not understand, you should 

eck legal advice. 

[7,) 

POWER 

OF ATTORNEY FOR JACK 

C. 

TACKEBURY

AGENT'S ACKNOWLEDGMENT 

» JENNIFER L. TACKEBURY , have been appointed agent for the principal JACK C. 

TACKEBURY, under a durable power of attorney dated January 17, 2025. By signing this 

document, I acknowledge that if and when I act as agent under the power, all of the following 

apply: 

MY DUTIES AS AGENT 

1 MUST: 

- Do what I know the principal reasonably expects me to do with the principal's property or, if I 

do not know the principal's expectations, act in the principal's best interest. 

2. Act in good faith. 

3- Do nothing beyond the authority granted in the durable power of attorney. 

4. Keep reasonable records of receipts, disbursements, and transactions I make on behalf of the 

principal. 

3- Disclose my identity as an agent whenever I act for the principal by writing or printing the 

principal's name and signing my own name as "agent". 

6. And depending on the terms of the power of attorney, I may have additional duties described 

ih section 114 of the uniform power of attorney act, MCL 556.201 to 556.505, including the 

presumptive duties to act loyally for the principal's benefit, avoid conflicts of interest that would 

ake it hard for me to act in the principal's best interest, and act with care, competence, and 

diligence. 

POWERS REQUIRING SPECIFIC AUTHORITY 

Unless specifically provided in the durable power of attorney or by judicial order, CANNOT 

IDO ANY OF THE FOLLOWING: 

1}. Create, amend, revoke, or terminate an inter vivos trust. 

2. Make a gift of the principal's property to someone else, let alone to myself. 

3} Create or change rights of survivorship by, for example, creating a joint account. 

4. Create or change a beneficiary designation. 

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. Delegate authority granted under the durable power of attorney. 

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OWER 

OF ATTORNEY FOR JACK C. 

TACKEBURY

- Exercise fiduciary powers that the principal has authority to delegate. 

(. Waive the principal's right to be a beneficiary of a joint and survivor annuity, including a 

urvivor benefit under a retirement plan. 

- Exercise authority over the content of electronic communications, as defined in 18 USC 25 10, 

gent or received by the principal. 

- Exercise authority over any bank, securities, or other financial account in a foreign country 

within the meaning of 

31 CFR 1010.350. 

TERMINATION OF MY AUTHORITY 

I must stop acting on behalf of the principal if I learn of any event that terminates the durable 

power of attorney or my authority under the power, including the death of the principal or the 

principal's revocation of either the power or my authority to act under it. 

MY POTENTIAL LIABILITY AS AGENT 

If I violate the uniform power of attorney act, MCL 556.201 to 556.505, or act outside the 

guthority granted in the durable power, 

I may be liable to the principal or the principal's 

successors for damages caused by my violation and to civil or criminal penalties. An exoneration 

dlause in the power (if any) does not relieve me of liability for acts or omissions committed in 

Bad faith or, in some cases, for acts or omissions committed with reckless indifference to the 

gurposes of the power of attorney or the interests of the principal. 

Signature: _ TL, \ 

Date; 

/~/7~F5 

JENNIFERAL. TACKEBURY 

If there is anything about this document or your duties that you do not understand, you should 

eek legal advice. 

[7] 

BE NE 

i 

Jay ews 

mgr 

’OWER 

OF ATTORNEY FOR JACK C. 

TACKEBURY 

10

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