POWER OF ATTORNEY
Date:
I/We
, hereby name and
Name
appoint to be my/our lawful attorney and to act
Name
for me/us to apply for certificate of title or registration.
Year Make
Vehicle Identification Number
X
Print Owners Name
Signature of Owner Date
Print Owners Name
X
Signature of Owner Date
Address City/State
Zip Telephone #
The signature of was subscribed and
sworn to before me at NH county of
on this the day of in the year of .
Notary/Justice of the Peace
Signed
Printed
My commission expires
*THIS FORM MUST BE NOTARIZED*
Note: Please sign name(s) as they appear on the title.
TITLE 5(Rev. 10/07)
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