New Jersey Power of Attorney for a Child
This Power of Attorney allows a parent or guardian to designate another adult to make decisions on behalf of a child.
Principal Information:
- Parent/Guardian Name: _______________
- Address: _______________
- City, State, Zip Code: _______________
- Phone Number: _______________
Agent Information:
- Agent Name: _______________
- Address: _______________
- City, State, Zip Code: _______________
- Phone Number: _______________
Child Information:
- Child's Name: _______________
- Child's Date of Birth: _______________
The Principal grants the Agent the authority to make decisions regarding the care, custody, and control of the child as follows:
- Healthcare decisions.
- Educational decisions.
- Travel consent.
- General welfare and safety decisions.
This Power of Attorney is effective on ______________ and shall remain in effect until ______________.
Signature of Parent/Guardian: ___________________________
Date: _______________
This document was acknowledged before me on ______________.
Notary Public Signature: ___________________________
My Commission Expires: _______________