This Power of Attorney for Minor Children is executed by the parents of minor children
to appoint an agent to take on the parental responsibilities of the children. The powers
granted to the agent can either be broad or narrow in scope, depending on the needs of
the parents. This is typically used to grant authority to the agent to make educational
and health care decisions for the children. The power of attorney is usually temporary in
duration and terminates on a specified date. It contains standard provisions and allows
opportunities for customization to address the specific needs of the parties. This
document should be used by parents that wish to appoint an agent to care for their
children.
POWER OF ATTORNEY FOR MINOR CHILDREN
THIS POWER OF ATTORNEY FOR MINOR CHILDREN, is made by
_________________________, of the City of _____________, in the State of ______________,
the biological mother/father (or both) of the minor children namely _________________, born
_____________ and ___________________ born ______________.
1. The undersigned hereby nominates, constitutes and appoints ____________________ as
the power of attorney and the temporary care giver and authority regarding the minor
children named above in accordance to ________ [Insert State] State law.
2. I/We hereby further nominate, constitute and appoint ___________________ as my/our
power of attorney over our minor children for the purposes of all of the day to day
parental responsibilities and decisions I/we would normally make for my/our minor
children named herein.
or
I/We hereby further nominate, constitute and appoint ___________________ as my/our
power of attorney over our minor children for the following specific purposes:
(i)
(ii)
(iii)
3. This Power of Attorney shall come into effect on the ____ day of _____________,
2_____ and shall terminate on the ______ day of ______________, 2____, unless earlier
revoked earlier by the undersigned.
4. The person being appointed Power of Attorney understands and agrees that by the
undersigned executing this Power of Attorney it does not convey legal custody of the said
minor children.
5. This Power of Attorney shall be construed, and enforced under the laws of _____ [Insert
State] in a court of competent jurisdiction.
I, the undersigned hereby duly swear I am of legal age and of sound mind and judgment to have
The full authority to sign and execute this Power of Attorney and my signature and execution is
of my own free will without constraint or undue influence.
Parent’s Signature: ________________________ Date: ________________
Parent’s Signature: ________________________ Date: ________________
SIGNED, SEALED AND DELIVERED )
in presence of )
)
)
)
A Notary Public for the State of ________ )
)
I, ___________________ [Insert Witness Name], the witness, sign my name to the foregoing
Power of Attorney that I duly swear that I in the presence of
____________________________[Insert Parent(s) Name(s)] had/have signed this Power of
Attorney willfully and without constraint or undue influence, and to the best of my knowledge
_______________________ [Insert Parent(s) Name(s)] is of legal age and of sound mind and
judgment.
Witness’s Signature: _________________________ Date: ______________________
[COMMENT: SOME STATES MAY REQUIRE THE WITNESS SIGNATURE IN
ORDER FOR THE POWER OF ATTORNEY TO BE VALID AND ENFORCEABLE IN
THE RESPECTIVE STATE. YOU SHOULD CHECK WITH YOUR LOCAL STATE
LAW TO DETERMINE IF THERE IS A WITNESS SIGNATURE REQUIREMENT.]
© Copyright 2013 Docstoc Inc. 2
INFORMATION AND FORMS ARE PROVIDED "AS IS" WITHOUT ANY EXPRESS OR IMPLIED WARRANTY OF ANY KIND
INCLUDING WARRANTIES OF MERCHANTABILITY, NONINFRINGEMENT OF INTELLECTUAL PROPERTY, OR FITNESS
FOR ANY PARTICULAR PURPOSE. IN NO EVENT SHALL DOCSTOC, INC., OR ITS AGENTS, OFFICERS, ATTORNEYS,
ETC., BE LIABLE FOR ANY DAMAGES WHATSOEVER (INCLUDING, WITHOUT LIMITATION, DAMAGES FOR LOSS OF
PROFITS, BUSINESS INTERRUPTION, LOSS OF INFORMATION) ARISING OUT OF THE USE OF OR INABILITY TO USE
THE MATERIALS, EVEN IF DOCSTOC HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. They are for
guidance and should be modified by you or your attorney to meet your specific needs and the laws of your state or jurisdiction. Use at
your own risk. Docstoc® is NOT providing legal or any other kind of advice and is not creating or entering into an Attorney-Client
relationship. The information, reports, and forms are not a substitute for the advice of your own attorney. The law is a personal matter
and no general information or forms or like the kind Docstoc provides can always correctly fit every circumstance.
Note: Carefully read and follow the Instructions and Comments contained in this document for your customization to suit your specific
circumstances and requirements. You will want to delete the Instructions and Comments from open bracket (“[“) to close bracket (“]”)
after reading and following them. You (or your attorney) may want to make additional modifications