New Hampshire Durable Power of Attorney
This Durable Power of Attorney document grants broad powers to an individual of your choice and is in accordance with the New Hampshire Revised Statutes Annotated (RSA) 506:6. It allows your chosen Agent or Attorney-in-Fact to make decisions on your behalf should you become unable to do so. Choosing someone you trust to act on your behalf is vital, as this document does not expire unless you revoke it or upon your death.
Principal Information
Name: ___________________________________________
Address: ________________________________________
City/State/ZIP: _________________________________
Phone Number: ___________________________________
Agent/Attorney-in-Fact Information
Name: ___________________________________________
Address: ________________________________________
City/State/ZIP: _________________________________
Phone Number: ___________________________________
Alternate Agent/Attorney-in-Fact Information (Optional)
Name: ___________________________________________
Address: ________________________________________
City/State/ZIP: _________________________________
Phone Number: ___________________________________
This document grants the following powers to the appointed Agent/Attorney-in-Fact, but not limited to:
- Real property transactions
- Tangible personal property transactions
- Stock and bond transactions
- Commodity and option transactions
- Banking and other financial institution transactions
- Business operating transactions
- Insurance and annuity transactions
- Estate, trust, and other beneficiary transactions
- Claims and litigation
- Personal and family maintenance
- Benefits from social security, Medicare, Medicaid, or other governmental programs, or military service
- Retirement plan transactions
- Tax matters
Effective Date of Power of Attorney: ___________________________________
This Durable Power of Attorney will continue to be effective even if I become disabled, incapacitated, or incompetent.
By signing this document, I affirm that I understand the significance of this Durable Power of Attorney, the powers granted to my Agent/Attorney-in-Fact, and declare that I am signing it voluntarily.
Principal’s Signature: ___________________________ Date: ____________
Agent/Attorney-in-Fact’s Signature: ________________ Date: ____________
State of New Hampshire
County of ______________________
On this day, ______________ (date), before me personally appeared _____________________________ (Principal’s name) and _____________________________ (Agent/Attorney-in-Fact’s name), known to me (or satisfactorily proven) to be the persons whose names are subscribed to the within instrument, and acknowledged that they executed the same for the purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
_________________________________
Notary Public
My commission expires: _______________