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Preview - Power of Attorney for a Child Form

Power of Attorney for Child

This document serves as a Power of Attorney for a Child under the laws applicable in the State of __________. It allows the designated individual to make decisions on behalf of the child named below in certain situations. This document should be completed in accordance with applicable state regulations.

1. Designation of Attorney-in-Fact

I, the undersigned parent or guardian, hereby appoint:

Full Name of Attorney-in-Fact: ____________________________

Address: _____________________________________________

Phone Number: ____________________________________

2. Child Information

Full Name of Child: ______________________________

Date of Birth: ______________________________

Address: ____________________________________

3. Powers Granted

The Attorney-in-Fact shall have the authority to:

  • Make medical decisions on behalf of the child.
  • Consent to medical treatment or surgical procedures.
  • Make educational decisions, including school enrollment.
  • Manage any financial matters related to the child.
  • Authorize participation in extracurricular activities.

4. Duration of Power of Attorney

This Power of Attorney shall be effective from __________ (start date) until __________ (end date), unless revoked in writing prior to that date.

5. Signatures

By signing below, I affirm that I am the parent or guardian of the child named and that I have the authority to execute this document.

Signature of Parent/Guardian: ______________________________

Date: ______________________________

6. Notarization (if required by state law)

State of __________

County of __________

Subscribed and sworn to before me this _____ day of __________, 20__.

Notary Public Signature: ______________________________

My Commission Expires: ______________________________

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