California Power of Attorney for a Child
This Power of Attorney is created pursuant to the laws of the State of California. It grants certain powers to another individual regarding the care and decisions for my child.
1. Principal Information:
Name: ____________________________________________
Address: __________________________________________
City: _______________________ State: ___________ Zip: __________
2. Child Information:
Name: ____________________________________________
Date of Birth: ______________________________________
Address: __________________________________________
3. Attorney-in-Fact Information:
Name: ____________________________________________
Address: __________________________________________
City: _______________________ State: ___________ Zip: __________
Relationship to Child: ______________________________
4. Powers Granted: The Attorney-in-Fact shall have the authority to:
- Make decisions relating to the child's health care.
- Provide for the child's education.
- Make decisions regarding the child's welfare and activities.
- Act on behalf of the child in legal matters, if necessary.
5. Effective Date: This Power of Attorney shall be effective on the following date: ________________ and shall remain in effect until revoked.
6. Signature:
Signature of Principal: ______________________________________
Date: ________________
7. Notary Acknowledgment:
State of California
County of ___________________
On ________________, before me, ______________________, a Notary Public in and for said County and State, personally appeared _______________________________________ known to me to be the person whose name is subscribed to this instrument, and acknowledged that he/she executed the same.
Notary Public Signature: ______________________________________
My Commission Expires: _____________________________
This document serves to empower a designated individual with responsibilities regarding the child’s well-being. Make sure to consult with a legal professional to confirm compliance with all local laws and regulations.