Pennsylvania Power of Attorney for a Child
This document serves as a Power of Attorney for a child under the laws of the Commonwealth of Pennsylvania. It grants an individual the authority to make decisions on behalf of a minor child, ensuring that the child's interests are represented when parents or guardians are unavailable.
Principal (Parent/Guardian) Information:
- Name: ____________________________
- Address: ____________________________
- City, State, Zip Code: ____________________________
- Phone Number: ____________________________
Agent (Attorney-in-Fact) Information:
- Name: ____________________________
- Address: ____________________________
- City, State, Zip Code: ____________________________
- Phone Number: ____________________________
Child Information:
- Name: ____________________________
- Date of Birth: ____________________________
- Address: ____________________________
This Power of Attorney becomes effective on the following date: ____________________________.
Authority Granted:
The Agent granted authority through this document may act on behalf of the Principal regarding the following matters:
- Health care decisions
- Educational decisions
- Travel and relocation decisions
- Financial matters pertaining to the minor child
Limitations:
The Agent is not authorized to make the following decisions:
- To place the child for adoption
- To consent to the child’s marriage or divorce
- To consent to invasive medical procedures without prior consultation
Duration:
This Power of Attorney will remain in effect until revoked by the Principal or until the following date: ____________________________.
By signing below, I acknowledge the grant of authority to the Agent for the specified purposes and accept the terms outlined above.
Principal Signature: ____________________________
Date: ____________________________
Witness Signature: ____________________________
Date: ____________________________
Notary Public: ____________________________
Date of Notarization: ____________________________