Financial Power of Attorney - New Hampshire

NEW HAMPSHIRE DURABLE FINANCIAL POWER OF ATTORNEY

Important Information

This document creates a general financial power of attorney under the New Hampshire Uniform Power of Attorney Act, RSA chapter 564-E. It grants only the financial and property authority selected below and does not grant health-care decision-making authority.

Under RSA 564-E:104, a power of attorney created under the Act is durable unless it expressly provides that incapacity terminates it. Under RSA 564-E:105(a), a general power of attorney must be signed other than by electronic signature by the Principal, or in the Principal's conscious presence by a directed signer, and acknowledged before a notary public or other person authorized to take acknowledgments. The signed disclosure in Section 15 must be affixed to this power of attorney.

Under RSA 564-E:113(a), a person designated as Agent under a general power of attorney has no authority to act until that person signs other than by electronic signature and affixes the acknowledgment in Section 17. Each original or successor Agent must complete that requirement before acting.

1. Principal

I, [PRINCIPAL FULL LEGAL NAME], of [PRINCIPAL ADDRESS], appoint the Agent named below to act for me subject to this document and New Hampshire law.

2. Agent

Agent: [AGENT FULL LEGAL NAME]

Address: [ADDRESS]

Telephone: [TELEPHONE]

3. Successor Agents

If the Agent is unable or unwilling to act, I appoint:

First Successor Agent: [NAME, ADDRESS AND TELEPHONE]

If that person is unable or unwilling to act, I appoint:

Second Successor Agent: [NAME, ADDRESS AND TELEPHONE]

Under RSA 564-E:111(b), unless this document provides otherwise, a successor has the same authority as the original Agent and may not act until all predecessor Agents have resigned, died, become incapacitated, are no longer qualified, or have declined to serve.

4. Grant of General Authority

Initial each subject you grant. Initial “All Preceding Subjects” instead of each separate subject only if you intend to grant every listed general subject.

These subjects correspond to the general authority described in RSA 564-E:204 through 564-E:216. The detailed statutory meaning of each selected subject controls.

5. Specific Authority Withheld

I do not authorize the Agent to exercise any authority listed in RSA 564-E:201(a), including authority to:

1. create, amend, revoke, or terminate an inter vivos trust;
2. make a gift;
3. create or change rights of survivorship;
4. create or change a beneficiary designation;
5. delegate authority granted under this power of attorney;
6. waive my right to be a beneficiary of a joint and survivor annuity, including a survivor benefit under a retirement plan;
7. exercise a fiduciary power that I have authority to delegate; or
8. exercise authority over the content of my electronic communications under RSA 554-A:9.

This form grants no authority to create an interest in my property for the Agent or for a person whom the Agent is legally obligated to support. Do not alter this section without individualized advice from a New Hampshire attorney. Gift authority, if separately and expressly added, is also subject to RSA 564-E:201, 564-E:116(g), and 564-E:217, including New Hampshire's restriction on a gift that would leave the Principal without sufficient assets or income for care without relying on Medicaid, other public assistance, or charity.

6. Special Instructions and Limits

The following instructions may narrow the general authority initialed above. They do not add any authority withheld by Section 5:

[____________________________________________________________]

[____________________________________________________________]

7. Effective Date and Durability

This power of attorney is effective when executed. It is durable and is not terminated by my later incapacity.

RSA 564-E:109 permits a future date, event, or contingency to control effectiveness if the document so provides. If effectiveness depends on incapacity and no authorized person is able and willing to determine incapacity, RSA 564-E:109(c) uses a written determination by a physician for incapacity under RSA 564-E:102(12)(A), or by a judge or appropriate governmental official for incapacity under RSA 564-E:102(12)(B). Obtain New Hampshire legal advice before replacing this immediate-effective provision with springing language.

8. Agent's Duties

An Agent has no duties until accepting appointment under RSA 564-E:113(b). An Agent who accepts must comply with RSA 564-E:114, including the duties to:

1. act according to my reasonable expectations to the extent actually known and otherwise in my best interest;
2. act in good faith and only within the authority granted;
3. unless this document provides otherwise, act loyally for my benefit, avoid conflicts that impair impartial action, use the care, competence, and diligence ordinarily exercised by agents in similar circumstances, keep records of receipts, disbursements, and transactions, and cooperate with my health-care decision-maker; and
4. unless this document provides otherwise, provide an accounting or report within 60 days after a written request by a person listed in RSA 564-E:116(a). The statutory period is 7 days if the decision at issue affects health care and may be shortened by court order for good cause.

9. Compensation and Reimbursement

Choose one:

☐ The Agent may receive reimbursement and reasonable compensation as provided by RSA 564-E:112.

☐ The Agent may receive reimbursement of reasonable expenses but no compensation.

☐ Compensation will be determined as follows: [DESCRIBE].

10. Termination and Revocation

RSA 564-E:110 governs termination. This power terminates at my death, upon my revocation, upon a stated termination event, when its purpose is accomplished, or when no Agent remains able and authorized to act. Unless this document provides otherwise, filing a petition for divorce, annulment, separation, or a decree of nullity terminates a spouse-Agent's authority.

A later power of attorney does not revoke this one unless the later document states that this power or all earlier powers are revoked. Under RSA 564-E:110(d), termination is not effective as to an Agent or other person who acts in good faith without actual knowledge of termination. A written revocation should be delivered promptly to every Agent and person expected to rely on this document; obtain legal advice about notice or recording for particular property or transactions.

11. Reliance, Judicial Relief, and Liability

RSA 564-E:119 governs good-faith reliance on an acknowledged power of attorney. A person asked to accept it may request an Agent's certification of facts under penalty of perjury, an English translation, or a reasoned request for an opinion of counsel in the circumstances stated by that section.

RSA 564-E:116 allows the listed persons to petition a court of competent jurisdiction concerning effectiveness, termination, authority, gifts, construction, or Agent conduct. The court may issue injunctions and other appropriate relief. Attorney-fee awards against an Agent are conditional under RSA 564-E:116(e), including a clear fiduciary-duty violation or an unjustified failure to provide a requested accounting or report; this document does not promise automatic fee shifting.

Under RSA 564-E:117, an Agent who violates the Act may be held liable, and an Agent who knowingly, willfully, or recklessly violates it is liable, for restoration of property value and reimbursement of attorney's fees and costs paid on the Agent's behalf. This document does not impose an artificial liability cap, mandatory arbitration, jury waiver, or exclusive “probate court” forum.

12. Governing Law

New Hampshire law governs this power of attorney.

13. Principal's Signature and Acknowledgment

I sign this document voluntarily and intend to create a durable financial power of attorney.

Principal's Signature (not electronic): ____________________________________

Printed Name: [PRINCIPAL FULL LEGAL NAME]

Date: [__/__/____]

STATE OF NEW HAMPSHIRE

COUNTY OF [COUNTY]

This document was acknowledged before me on [__/__/____] by [PRINCIPAL FULL LEGAL NAME].

Notary Public or Other Authorized Officer: ______________________________

Printed Name: [________________________________]

Commission Expires: [__/__/____]

14. Optional Nomination in Protective Proceedings

If a court later considers a conservator for my estate or a guardian for my person, I nominate:

Conservator: [NAME, ADDRESS AND TELEPHONE]

Guardian: [NAME, ADDRESS AND TELEPHONE]

RSA 564-E:108 directs the court to make the appointment in accordance with the Principal's most recent nomination in a power of attorney if the nominee is qualified and willing to serve, except for good cause or disqualification.

15. Principal's Mandatory Disclosure Statement

The following disclosure must be signed other than by electronic signature by the Principal, or by another individual directed by the Principal to sign the Principal's name, and affixed to this general power of attorney under RSA 564-E:105(a)(2):

INFORMATION CONCERNING THE POWER OF ATTORNEY

THIS IS AN IMPORTANT LEGAL DOCUMENT. BEFORE SIGNING THIS DOCUMENT YOU SHOULD KNOW THESE IMPORTANT FACTS:

Notice to the Principal: As the “Principal,” you are using this Power of Attorney to grant power to another person (called the “Agent”) to make decisions, including, but not limited to, decisions concerning your money, property, or both, and to use your money, property, or both on your behalf. If this Power of Attorney does not limit the powers that you give to your Agent, your Agent will have broad and sweeping powers to sell or otherwise dispose of your property, and to spend your money without advance notice to you or approval by you. Unless you have expressly provided otherwise in this Power of Attorney, your Agent will have these powers before you become incapacitated, and unless you have expressly provided otherwise in this Power of Attorney, your Agent will continue to have these powers after you become incapacitated. You have the right to retain this Power of Attorney and to release it later or to request that another person retain this Power of Attorney on your behalf and release it only if one or more conditions specified in advance by you are satisfied. You have the right to revoke or take back this Power of Attorney at any time, so long as you are of sound mind. If there is anything about this Power of Attorney that you do not understand, you should seek professional advice.

Principal's Disclosure Signature (not electronic): __________________________

Printed Name: [PRINCIPAL FULL LEGAL NAME]

Date: [__/__/____]

16. Instructions to Every Agent and Successor Agent

Before acting, each person designated as Agent must manually sign a separate copy of the acknowledgment below and affix it to this power of attorney. A signature on the Principal's execution block or a generic acceptance is not a substitute for RSA 564-E:113(a).

17. Mandatory Agent Acknowledgment

I, ______________________________ , have read the attached power of attorney and am the person identified as the agent for the principal. I hereby acknowledge that when I act as agent, I am given power under the power of attorney to make decisions about money, property, or both belonging to the principal, and to spend the principal's money, property, or both on the principal's behalf, in accordance with the terms of the power of attorney. When acting as agent, I have duties (called “fiduciary duties”) to act in accordance with the principal's reasonable expectations to the extent actually known by me and, otherwise, in the principal's best interest, to act in good faith, and to act only within the scope of authority granted in the power of attorney, as well as other duties imposed by law to the extent not provided otherwise in the power of attorney. As an agent, I am not entitled to use the money or property for my own benefit or to make gifts to myself or others unless the power of attorney specifically gives me the authority to do so. As an agent, my authority under the power of attorney will end when the principal dies and I will not have authority to manage or dispose of any property or administer the estate of the principal. If I violate a fiduciary duty under the power of attorney, I may be liable for damages and may be subject to criminal prosecution. If there is anything about the power of attorney, or my duties under it, that I do not understand, I understand that I should seek professional advice.

Agent's Signature (not electronic): ____________________________________

Printed Name: [AGENT OR SUCCESSOR AGENT NAME]

Capacity: ☐ Original Agent ☐ First Successor ☐ Second Successor

Date: [__/__/____]

Duplicate and complete this acknowledgment for each person who will act.

Sources and References

• New Hampshire Uniform Power of Attorney Act, RSA chapter 564-E: https://gc.nh.gov/rsa/html/LVI/564-E/564-E-mrg.htm
• RSA 564-E:104 and 564-E:105: https://gc.nh.gov/rsa/html/LVI/564-E/564-E-104.htm and https://gc.nh.gov/rsa/html/LVI/564-E/564-E-105.htm
• RSA 564-E:108, 564-E:109, and 564-E:110: https://gc.nh.gov/rsa/html/LVI/564-E/564-E-108.htm, https://gc.nh.gov/rsa/html/LVI/564-E/564-E-109.htm, and https://gc.nh.gov/rsa/html/LVI/564-E/564-E-110.htm
• RSA 564-E:111 through 564-E:114: https://gc.nh.gov/rsa/html/LVI/564-E/564-E-111.htm, https://gc.nh.gov/rsa/html/LVI/564-E/564-E-112.htm, https://gc.nh.gov/rsa/html/LVI/564-E/564-E-113.htm, and https://gc.nh.gov/rsa/html/LVI/564-E/564-E-114.htm
• RSA 564-E:116, 564-E:117, and 564-E:119: https://gc.nh.gov/rsa/html/LVI/564-E/564-E-116.htm, https://gc.nh.gov/rsa/html/LVI/564-E/564-E-117.htm, and https://gc.nh.gov/rsa/html/LVI/564-E/564-E-119.htm
• RSA 564-E:201, 564-E:217, and 564-E:301: https://gc.nh.gov/rsa/html/LVI/564-E/564-E-201.htm, https://gc.nh.gov/rsa/html/LVI/564-E/564-E-217.htm, and https://gc.nh.gov/rsa/html/LVI/564-E/564-E-301.htm