Free New Hampshire Power of Attorney Form


Sample New Hampshire Power of Attorney

POWER OF ATTORNEY


THIS Power of Attorney
is given by me, _______________ (the “Principal”), presently of _______________, _______________, in the State of New Hampshire, on this _________ day of _____________, 20___.

    Previous Power of Attorney

  1. I REVOKE any previous Power of Attorney granted by me.
  2. Attorney-in-fact

  3. I APPOINT __________________, of ___________________________, __________________, New Hampshire, to act as my Attorney-in-fact.
  4. Governing Law

  5. This document will be governed by the laws of the State of New Hampshire. Further, my Attorney-in-fact is directed to act in accordance with the laws of the State of New Hampshire at any time he or she may be acting on my behalf.
  6. Liability of Attorney-in-fact

  7. My Attorney-in-fact will not be liable to me, my estate, my heirs, successors or assigns for any action taken or not taken under this document, except for willful misconduct or gross negligence.
  8. Effective Date

  9. This Power of Attorney will start immediately and will cease to be in effect upon a finding of my mental incapacity or mental infirmity which may occur after my execution of this Power of Attorney.
  10. Powers of Attorney-in-fact

  11. My Attorney-in-fact has authority to do anything on my behalf that I may lawfully do by an Attorney-in-fact (the “General Power”).
  12. Specific Powers

  13. Without restricting its generality in any way, the following power(s) are specifically included within the foregoing General Power:

    Initial the line at each authority you grant

      X_____Real Estate Transactions

    1. To deal with any interest I may have in real property and sign all documents on my behalf concerning my interest, including, but not limited to, real property I may subsequently acquire or receive. These powers include, but are not limited to, the ability to:

       

      i.

      Purchase, sell, exchange, accept as gift, place as security on loans, convey with or without covenants, rent, collect rent, sue for and receive rents, eject and remove tenants or other persons, to pay or contest taxes or assessments, control any legal claim in favor of or against me, partition or consent to partitioning, mortgage, charge, lease, surrender, manage or otherwise deal with real estate and any interest therein; and

       

      ii.

      Execute and deliver deeds, transfers, mortgages, charges, leases, assignments, surrenders, releases and other instruments required for any such purpose.

    2. X_____Maintain Property and Make Investments

    3. To retain any assets owned by me at the date this Ordinary Power of Attorney becomes effective, and the power to reinvest those assets in similar investments. In addition, my Attorney-in-fact may invest my assets in any new investments, of his or her choosing, regardless of whether or not they are authorized by any applicable legislation.

    4. X_____Banking Transactions

    5. To do any act that I can do through an Attorney-in-fact with a bank or other financial institution. This power includes, but is not limited to, the power to:

       

      i.

      Open, maintain or close bank accounts (including, but not limited to, checking accounts, savings accounts, and certificates of deposit), brokerage accounts, retirement plan accounts, and other similar accounts with financial institutions;

       

      ii.

      Conduct any business with any banking or financial institution with respect to any of my accounts, including, but not limited to, making deposits and withdrawals, negotiating or endorsing any checks or other instruments with respect to any such accounts, obtaining bank statements, passbooks, drafts, money orders, warrants, and certificates or vouchers payable to me by any person, firm, corporation or political entity;

       

      iii.

      Borrow money from any banking or financial institution if deemed necessary by my Attorney-in-fact, and to manage all aspects of the loan process, including the placement of security and the negotiation of terms;

       

      iv.

      Perform any act necessary to deposit, negotiate, sell or transfer any note, security, or draft of the United States of America, including U.S. Treasury Securities;

       

      v.

      Have access to any safe deposit box that I might own, including its contents; and

       

      vi.

      Create and deliver any financial statements necessary to or from any bank or financial institution.

    6. X_____Business Operating Transactions

    7. To take any action my Attorney-in-fact deems necessary with any business that I may own or have an interest in by doing any act which can be done through an Attorney-in-fact. This power includes, but is not limited to, the power to execute, seal and deliver any instrument; participate in any legal business of any kind; execute partnership agreements and amendments; to incorporate, reorganize, consolidate, merge, sell, or dissolve any business; to elect or employ officers, directors and agents; and to exercise voting rights with respect to any stock I may own, either in person or by proxy.

    8. X_____Insurance Transactions

    9. To do any act that I can do through an Attorney-in-fact with any insurance policy. This power includes, but is not limited to, the power to pay premiums, start, modify or terminate policies, manage all cash payouts, borrow from insurers and third parties using insurance policies as collateral, and to change the beneficiaries on any insurance policies on my life. Unless my Attorney-in-fact was already a beneficiary of any policy before the signing of this document, my Attorney-in-fact cannot name himself or herself as a beneficiary of such policy.

    10. X_____Claims and Litigation Matters

    11. To institute, maintain, defend, compromise, arbitrate or otherwise dispose of, any and all actions, suits, attachments or other legal proceedings for or against me. This power includes, but is not limited to, the power to: appear on my behalf, and the power to settle any claim against me in whichever forum or manner my Attorney-in-fact deems prudent, and to receive or pay any resulting settlement.

    12. X_____Tax Matters

    13. To act for me in all matters that affect my local, state and federal taxes and to prepare, sign, and file documents with any governmental body or agency, including, but not limited to, authority to:

       

      i.

      Prepare, sign and file income and other tax returns with federal, state, local and other governmental bodies, and to receive any refund checks; and

       

      ii.

      Obtain information or documents from any government or its agencies, and represent me in all tax matters, including the authority to negotiate, compromise, or settle any matter with such government or agency.

    14. X_____Government Benefits

    15. To act on my behalf in all matters that affect my right to allowances, compensation and reimbursements properly payable to me by the Government of the United States or any agency or department thereof. This power includes, but is not limited to, the power to prepare, file, claim, defend or settle any claim on my behalf and to receive and manage, as my Attorney-in-fact sees fit, any proceeds of any claim.

    16. X_____Retirement Benefit Transactions

    17. To act for me and represent my interests in all matters affecting any retirement savings or pension plans I may have. This power includes, but is not limited to, the power to continue contributions, change contribution amounts, change investment strategies and options, move assets to other plans, receive and manage payouts, and add or change existing beneficiaries. My Attorney-in-fact cannot add himself or herself as a beneficiary unless he or she is already a designated beneficiary as of the signing of this document.

    18. X_____Family Care

    19. To make whatever expenditures are required for the maintenance, education, benefit, medical care and general advancement of me, my spouse and dependent children, and other persons that I have chosen or which I am legally required to support, any of which may include my Attorney-in-fact. This power includes, but is not limited to, the power to pay for housing, clothing, food, travel and other living costs.

    20. X_____Chattel and Goods Transactions

    21. To purchase, sell or otherwise deal with any type of personal property I may currently or in the future have an interest in. This includes, but is not limited to, the power to purchase, sell, exchange, accept as gift, place as security on loans, rent, lease, to pay or contest taxes or assessments, mortgage or pledge.

    22. X_____Estate Transactions

    23. To do any act that I can do through an Attorney-in-fact with regard to all matters that affect any trust, probate estate, conservatorship, or other fund from which I may receive payment as a beneficiary. This power includes the power to disclaim any interest which might otherwise be transferred or distributed to me from any other person, estate, trust, or other entity, as may be appropriate. However, my Attorney-in-fact cannot disclaim assets to which I would be entitled, if the result is that the disclaimed assets pass directly or indirectly to my Attorney-in-fact or my Attorney-in-fact’s estate.

    24. X_____Living Trust Transactions

    25. To transfer any of my assets to the trustee of any revocable trust created by me, if such trust is in existence at the time of such transfer. This property can include real property, stocks, bonds, accounts, insurance policies or other property.

    26. X_____Gift Transactions

    27. To make gifts to my spouse, children, grandchildren, great grandchildren, and other family members on special occasions, including birthdays and seasonal holidays, including cash gifts, and to such other persons with whom I have an established pattern of giving (or if it is appropriate to make such gifts for estate planning and/or tax purposes), in such amounts as my Attorney-in-fact may decide in his or her absolute discretion, having regard to all of the circumstances, including the gifts I made while I was capable of managing my own estate, the size of my estate and my income requirements.

    28. X_____Charity Transactions

    29. To continue to make gifts to charitable organizations with whom I have an established pattern of giving (or if it is appropriate to make such gifts for estate planning and/or tax purposes), in such amounts as my Attorney-in-fact may decide in his or her absolute discretion, having regard to all of the circumstances, including the gifts I made while I was capable of managing my own estate, the size of my estate and my income requirements.

    30. X_____Employ Required Professionals

    31. To appoint and employ any agents, servants, companions, or other persons, including nurses and other health care professionals for my care and the care of my spouse and dependent children, and accountants, attorneys, clerks, workers and others for the management, preservation and protection of my property and estate, at such compensation and for such length of time as my Attorney-in-fact considers advisable.

      X_____Manage Real Estate

    32. To manage the property owned by me, or in which I have an interest, located at _____________________________________________________, and municipally known as _____________________________________________________. This power includes, but is not limited to, the power to receive rents, make repairs, pay expenses including the insuring of the property and generally to deal with my property as effectually as I myself could do; to take all lawful proceedings by way of action or otherwise, for recovery of rent in arrears, or for eviction of tenants; and to commence, carry on and defend all actions, suits and other proceedings touching my property or any part of it.

    33. X_____Manage Specific Financial Account

    34. To control my accounts with ____________________ Bank, located at _________________________________________, Account Number(s)__________________________________________. This power includes the authority to conduct any business with respect to any of my listed accounts, including, but not limited to, making deposits and withdrawals, negotiating or endorsing any cheques or other instruments with respect to any such accounts, obtaining bank statements, passbooks, drafts, money orders, warrants, and certificates or vouchers payable to me by any person, firm, corporation or political entity, and to perform any act necessary to deposit, negotiate, sell or transfer any note, security or draft.

  14. Attorney-in-fact Compensation

  15. My Attorney-in-fact will receive no compensation except for the reimbursement of all out of pocket expenses associated with the carrying out of my wishes.
  16. Co-owning of Assets and Mixing of Funds

  17. My Attorney-in-fact may not mix any funds owned by him or her in with my funds and all assets should remain separately owned if at all possible.
  18. Personal Gain from Managing My Affairs

  19. My Attorney-in-fact is not allowed to personally gain from any transaction he or she may complete on my behalf.
  20. Delegation of Authority

  21. My Attorney-in-fact may not delegate any authority granted under this document.
  22. Attorney-in-fact Restrictions

  23. This Power of Attorney is not subject to any conditions or restrictions other than those noted above.
  24. Notice to Third Parties

  25. Any third party who receives a valid copy of this Power of Attorney can rely on and act under it. A third party who relies on the reasonable representations of my Attorney-in-fact as to a matter relating to a power granted by this Power of Attorney will not incur any liability to the Principal or to the Principal’s heirs, assigns, or estate as a result of permitting the Attorney-in-fact to exercise the authority granted by this Power of Attorney up to the point of revocation of this Power of Attorney. Revocation of this Power of Attorney will not be effective as to a third party until the third party receives notice and has actual knowledge of the revocation.
  26. Severability

  27. If any part of any provision of this document is ruled invalid or unenforceable under applicable law, such part will be ineffective to the extent of such invalidity only, without in any way affecting the remaining parts of such provisions or the remaining provisions of this document.
  28. Acknowledgment

  29. I, _______________, being the Principal named in this Power of Attorney hereby acknowledge:
    1. I have read and understand the nature and effect of this Power of Attorney;
    2. I am of legal age in the State of New Hampshire to grant a Power of Attorney; and
    3. I am voluntarily giving this Power of Attorney.

IN WITNESS WHEREOF
I hereunto set my hand and seal at the City of ________________ in the State of New Hampshire, this _________ day of _____________, 20___.

SIGNED, SEALED, AND DELIVERED

     

in the presence of:

     
       

Witness: ______________________ (Sign)

     

Witness Name: ______________________

     

Address: ___________________________

   

__________________________________

___________________________________

   

_______________ (Principal)

       

Witness: ______________________ (Sign)

     

Witness Name: ______________________

     

Address: ___________________________

     

___________________________________

   


WITNESS CERTIFICATE

I, _________________________, currently residing at __________________________, in the City of __________________, in the State of ____________________, hereby acknowledge that:

  1. I witnessed the signing of the Power of Attorney of _______________ dated this _________ day of _____________, 20___.
  2. I am an adult with capacity to witness the signing of the Power of Attorney and I am the subscribing witness thereto.
  3. In my opinion, _______________ had the capacity to understand the nature and effect of the Power of Attorney at the time the Power of Attorney was signed and the Principal signed it freely and voluntarily without any compulsion or influence from any person.
  4. I am not the Attorney-in-fact named in the Power of Attorney nor am I the Attorney-in-fact’s spouse or other family member.

_________________________

_________________________

(Signature of Witness)

(Date)


WITNESS CERTIFICATE

I, _________________________, currently residing at __________________________, in the City of __________________, in the State of ____________________, hereby acknowledge that:

  1. I witnessed the signing of the Power of Attorney of _______________ dated this _________ day of _____________, 20___.
  2. I am an adult with capacity to witness the signing of the Power of Attorney and I am the subscribing witness thereto.
  3. In my opinion, _______________ had the capacity to understand the nature and effect of the Power of Attorney at the time the Power of Attorney was signed and the Principal signed it freely and voluntarily without any compulsion or influence from any person.
  4. I am not the Attorney-in-fact named in the Power of Attorney nor am I the Attorney-in-fact’s spouse or other family member.

_________________________

_________________________

(Signature of Witness)

(Date)

In a bid to protect your interests, you have to name someone you trust to act as your proxy should you need someone you trust to take care of your business if you have to be away from the state for extended periods or weeks. And, physically handing over keys or introducing that person to your employees is not enough. Neither is mentioning in passing that you don’t wish to stay hooked to machines if your body fails. You need to make things official using a power of attorney.

A power of attorney (POA) is a legal instrument you use to name someone else as your proxy or the executor of your estate, or your health care decision maker should you be incapacitated. Being legally binding, your proxy, also called the agent or the attorney-in-fact will only according to your wishes. A written and signed document also adds weight to the document and the agent will know that they are taking on a huge task which they will be taken in court should they fail to honor your directives.

And, the other things that protect you once you sign a POA is that you can indicate in the document that the powers granted should only be executed when you are medically incapacitated and unable to make sound medical or financial decisions. This refers to springing powers of attorney.

With that out of the ways, which are the main types of POA documents and which are the applicable laws?

  • In the free New Hampshire power of attorney form, you’ll come across:

    • 1. The New Hampshire Durable POA (DPOA)

The most important POA, the durable POA is the legal instrument that an agent uses to give or refuse to give consent to medical procedures and treatments. It carries your directives relating to your healthcare, and it’s also referred to as the durable healthcare POA. Your proxy will guide the doctors on your preferred end of life process.

In your free power of attorney in New Hampshire, you will note that the durable POA is created according to the states code section 137-J:1 et seq. which has the provisions of the durable POA for healthcare.

Powers of the DPOA

The chosen agent can give consent, withdraw, or refuse to give their consent to a principal’s admission into a facility, treatment, care, as well as services or procedures for maintenance, treatment and the diagnosis of the principal’s mental or physical condition.

However artificial hydration and nutrition will not be withdrawn or even withheld from the principal unless such wishes are expressed in the POA.

The powers of the agent will not include consenting to a voluntary admission into a state institution, consenting to have life-supporting treatment for a pregnant patient withdrawn, unless the treatment will not allow continued healthy development of the unborn child or their live birth. The powers will also not cover voluntary sterilization.

  • The DPOA legal requirements

    • It should be in writing and accordance with the New Hampshire statutory form

    • The presence of a subscribing witness (es) to affirm that at the time of preparing the document, the principal was of sound mind, they were aware of the document, and they acted out of their own volition.

    • Its disclosure should be similar to the contents of form §137-J:14 before the document is executed.

A DPOA from a different state is executable only if it complies with the laws of that state/ jurisdiction, and the foreign instrument must comply with the New Hampshire laws.

If a healthcare provider or an attending is unwilling to comply with the directives, they should inform the agent then help transfer the patient to a different facility.

But, an attending physician acting in good faith will not be criminally, professionally, or civilly liable.

  • Revocation of the DPOA

    • The principal can revoke the document by notifying their agent or the healthcare provider of their intention to revoke the POA. This should be in writing or through verbal expression.

    • Execution of a new POA

    • Filing of a divorce if the spouse is the agent

    • The revocation of the document will be done as soon as the healthcare provider or the agent receives notice.

    • Also, a person directly interested in the principal can file for revocation of the DPOA if they believe that the principal signed the POA under duress, when not of sound mind, under undue influence, and through fraudulent means.

    • 2. New Hampshire Limited POA

  • Should you wish to have your agent act on specific powers, a limited POA will do the trick. With the limited POA, the agent only acts on specific matters if you are incapacitated or out of town and unable to make some decisions. You rescind the powers of the POA by issuing a written POA to your agent and affected third parties.

    • 3. New Hampshire POA For Bank Account Matters

This is a specific POA which you use to give your agent specific powers over your bank account for as long as you are unavailable or unable to act. The powers of the POA are only revoked if you send a written notice to the agent and third parties acting on the directives of the agent.

Would you like to get a POA instrument processed today? Get our free power of attorney form online now. Whether you live in Manchester, Concord, Nashua or other city of New Hampshire, you can use POA legal forms easily.

Sample

NH Power of Attorney

Personalize your Power of Attorney template.

Print or download in minutes.