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New Hampshire Revocation Power of Attorney Form

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New Hampshire Revocation Power of Attorney Form is used when you want to revoke a previously entered into power of attorney. When you decide to revoke such a document, it is important that you fill out this form and make sure the relevant parties receive a copy of it. The purpose of this paperwork will be to inform the agent of your decision to terminate the principal power designated to him or her and to provide physical proof of the calendar date this decision became effective. Any entity (i.e. financial institutions) that has been dependent or exposed to the power of attorney you are revoking should receive a properly executed copy of this paperwork as well.

How to Write

1 – Download And Fill Out The Appointment Revocation Paperwork

Open this form with the buttons under the preview image on this page. Take a moment to review this paperwork then download or print it so that you may fill it out.

2 – Differentiate The Type Of Authority That Must Be Revoked Here

Generally, there are two types of Authority that are commonly delegated to an Attorney-in-Fact: Financial and Medical. Use the check boxes at the top of the page indicate what types of Powers are being revoked. If the Authority being revoked does not fit either of these categories then mark the box labeled “Other” and fill in the category on the blank lines provided.

3 – Declare The Principal’s Identity

All paperwork that delegates Principal Power to an Attorney-in-Fact will document the Name of the Principal. This revocation form will have the same requirement. After indicating the Type of Power being revoked, enter the Principal’s Full Name on the first blank line in the paragraph statement.

4 – Clearly Name The Authority Paperwork To Be Revoked

This paperwork will also need to clearly present the Title of the Document being revoked. Fill in the exact Title of the Power Appointment being revoked on the second blank space. Then you will need to fill in the Execution Date when the previous delegation of Authority was executed or signed by the Principal.

5 – Present The Attorney-in-Fact Appointed With The Revoked Powers

The Name of the Attorney-in-Fact, who currently holds the Principal Authority to be Revoked, must be reported on the next blank line. The next blank line in this statement will require you produce the Name(s) of any Alternate Attorney-in-Fact who have also been named as the recipient of Principal Authority in the Revoked Paperwork.

6 – The Principal Must Sign This Revocation

The final statement of this document will call for the Principal’s Date of Signature, the Principal’s Signature, and the Principal’s Printed Name. Only the Principal can satisfy these items.

This document must be Notarized. The final segment of this paperwork will provide the space for a Notary Public to notarize this signing.


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