New Hampshire Power of Attorney Template
This Power of Attorney ("POA") document is a legal form that lets you, the Principal, appoint someone you trust, known as the Agent or Attorney-in-Fact, to manage your affairs in the State of New Hampshire. This document is designed to comply with the New Hampshire Revised Statutes Annotated (RSA) Chapter 564-E, known as the New Hampshire Uniform Power of Attorney Act.
Before completing this form, it’s crucial to pick an Agent who is reliable and capable, as this person will have significant power over your affairs. You should also discuss the responsibilities with the chosen Agent to ensure they understand and accept the role.
Principal Information
Full Name: ___________________________
Address: _____________________________
City: ________________________________
State: New Hampshire ZIP Code: ________
Phone Number: ________________________
Agent/Attorney-in-Fact Information
Full Name: ___________________________
Address: _____________________________
City: ________________________________
State: _______________________________
ZIP Code: ___________________________
Phone Number: ________________________
Powers Granted
Select the powers you wish to grant to your Agent by placing a check beside each applicable power. The powers listed below are intentionally broad to cover a wide range of legal and financial actions that the Agent may need to perform on your behalf:
- 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
For any power you do not wish to grant, please strike through the item or write "Not Applicable."
Duration of Power
Unless specified otherwise, this Power of Attorney will become effective immediately upon signing and will remain in effect until it is revoked. Should you wish to specify a different starting date, duration, or condition upon which the Power will terminate, please provide those details below:
Effective Date: _______________________
Termination Date or Condition: __________
Signature
By signing below, the Principal acknowledges and agrees to the terms and powers granted in this Power of Attorney document.
Principal’s Signature: _______________________ Date: ___________
Agent/Attorney-in-Fact’s Signature: ____________ Date: ___________
State of New Hampshire
County of _______________________
This document was signed before me on (date) ______________ by (name of Principal) _______________________.
Notary Public’s Signature: __________________________
My Commission Expires: ______________
This Power of Attorney document provides a structured format for individuals in New Hampshire to appoint an Agent to manage a wide range of tasks, from financial transactions to real estate dealings. It is adaptable to the Principal's needs, including flexible terms for the POA's effectiveness and duration. Users should fill in the blanks with their personal information and the details of their chosen Agent, then review and adjust the powers granted as needed. Notarization by a Notary Public confirms the identity of the signing parties and the document's validity within New Hampshire.