New Hampshire Durable Power of Attorney with Guardian Provision If Guardian Becomes Necessary


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                             This Durable Power of Attorney with Guardian Provision is used by individuals located in
                             New Hampshire for the purpose of granting an Attorney-in-Fact the power to manage a
                             principal's assets and financial affairs. It gives the principal's attorney the power to buy or
                             sell property, collect money, file taxes and sue on behalf of the principal. This document
                             contains a provision that appoints the attorney as guardian or conservator of the principal's
                             estate, should it become necessary. This power of attorney becomes effective upon its
                             execution and remains in effect in event of the principal's disability or incapacity.

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                      BECOMES NECESSARY

KNOW ALL MEN BY THESE PRESENTS, That I, ____________________________
[Instruction: Insert the name of Principal] residing at ______________________________
[Instruction: Insert the address of Principal] (hereinafter referred to as the “Principal”), have
made, constituted and appointed, ____________________________ [Instruction: Insert the
name of Agent] residing at _________________________________ [Instruction: Insert the
address of Agent], as my true and lawful attorney (hereinafter referred to as “Attorney-in-
Fact”), to operate for me and in my name, place and stead, and for my use and benefit.

This Power of Attorney shall not be affected by my disability, incompetency or incapacity;


1. Attorney-in-Fact is hereby empowered to ask, demand, sue for, recover, collect and receive
   all such sums of money, debts, dues, accounts, legacies, bequests, interests, dividends,
   annuities and demands whatsoever as are now, or shall hereafter become due, owing, payable
   or belonging to me, and have, use and take all lawful ways and means in my name or
   otherwise for the recovery thereof, to bargain, contract, agree to, purchase, receive and take
   lands, tenements and hereditaments, and accept the seizing and possession of all lands and all
   deeds and other assurances, in the law therefor, and to lease, let, demise, bargain, sell,
   remise, release, convey, mortgage and hypothecate lands, tenements and hereditaments, upon
   such terms and conditions, and under such covenants as Attorney-in-Fact shall think fit.

2. Attorney-in-Fact can bargain and agree for, buy, sell, mortgage, hypothecate and in any and
   every way and manner deal in and with goods, wares and merchandise, chooses in action and
   other property in possession or in action, and to make, do and transact all and every kind of
   business of what nature or kind so ever, and also for me and in my name, and as my act and
   deed, to sign, seal, execute, deliver and acknowledge such deeds, leases and assignment of
   leases, covenants, indentures, agreements, mortgages, hypothecations, bills, bonds, notes,
   receipts, evidences of debts, releases and satisfaction of mortgages, judgments and other
   debts, and such other instruments in writing of whatever kind and nature as may be necessary
   or proper.

3. Attorney-in-Fact shall have unrestricted access to, and the right to enter into, any safety
   deposit box, vault, storage warehouse or other depository which I may lease or own, which
   may be registered in my name, or in which any property may be held for me.

4. Attorney-in-Fact shall have the power to prepare, make, execute and file any and all federal,
   state, local or other tax returns, claims for refunds or declarations of estimated tax. This
   power shall include the power to represent me (directly or through attorneys, accountants or
   other agents) in any matter before the Internal Revenue Service or any other federal, state or
   local agency. In connection with such representation, Attorney-in-Fact may execute consents
   extending the statutory period for the assessment or collection of taxes, may pay all taxes and
   interest thereon which I may properly owe or which may be assessed against me, and may
   contest the validity of any proposed assessment.

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Giving and granting unto Attorney-in-Fact full power and authority to do and perform all and
every act and thing whatsoever requisite and necessary to be done in and about the premises as
fully to all intents and purposes as I might or could do if personally present, with full power of
substitution or revocations, hereby ratifying and confirming all that Attorney-in-Fact shall
lawfully do or cause to be done by virtue of these presents.

In the event that it shall become necessary for any Court for a guardian to be appointed over my
estate, I hereby direct that Attorney-in-Fact shall serve as such guardian/conservator.

WITNESS my hand this _______ [Month] _______ [Date], 20_____

[Instruction: Insert signature of Principal]

[Instruction: Insert typed/printed name of Principal]

[Instruction: Insert signature of Agent]

[Instruction: Insert typed/printed name of Agent]

Signed sealed and delivered in the presence of:

[Instruction: Insert signature of Witness #1]


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[Instruction: Insert name and address of Witness #1]

[Instruction: Insert signature of Witness #2]


[Instruction: Insert name and address of Witness #2]

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STATE OF New Hampshire

COUNTY OF ______________________

I, _________________________, a Notary Public in and for said County and State, hereby
certify that _______________________, whose name is signed to the foregoing instrument and
who is known to me, acknowledged before me on this day that, being of the contents of the said
instrument, he/she executed the same voluntarily on the day the same bears date.

Given under my hand this _____ day of __________


                                                                      Notary Public

                                               Printed Name: ____________________________

                                               My Commission Expires: ___________________

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