Durable Power Of Attorney Form - New Hampshire Page 2
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6V. PRINCIPAL - I, ______________________, residing at
Name of Principal
_________________________________________________________________
Street Address of Principal
City of ______________________, State of ______________________, appoint
City of Principal
State of Principal
the following as my Attorney-in-Fact, whom I trust with any and all my
financial decision making power immediately upon the authorization of this
form, and in the event that I should become incapacitated:
VI. ATTORNEY-IN-FACT - ______________________, residing at
Name of Attorney-in-Fact
_________________________________________________________________
Street Address of Attorney-in-Fact
City of ______________________, State of ______________________ grant
City of Attorney-in-Fact
State of Attorney-in-Fact
the Attorney-in-Fact the legal authority to act on my behalf for any power legal
under law in regard to my financial decisions under the State of
_________________________.
State
VII. SUCCESSOR ATTORNEY-IN-FACT (Optional) – If the Attorney-in-Fact named
above cannot or is unwilling to serve, then I appoint ______________________,
Name of Successor Attorney-in-Fact
residing at
____________________________________________________________________
Street Address of Successor Attorney-in-Fact
City of ______________________, State of ______________________ grant
City of Successor Attorney-in-Fact
State of Successor Attorney-in-Fact
the Attorney-in-Fact the legal authority to act on my behalf for any power legal
under law in regard to my financial decisions under the State of
_________________________.
State
VIII. TERMS & CONDITIONS – Upon authorization by all parties, the Attorney-in-
Fact accepts their designation to act in the Principal’s best interests for all
financial decisions legal under law.
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