Pennsylvania Power of Attorney for a Child
This Power of Attorney is executed in accordance with the laws of the Commonwealth of Pennsylvania.
This document grants permission to the designated individual to make decisions on behalf of a minor child.
1. Designation of Agent
I, [Parent/Guardian's Full Name], residing at [Address], hereby appoint [Agent's Full Name], residing at [Agent's Address], as my agent for my child.
2. Child's Information
The child for whom this Power of Attorney is granted is:
- Name: [Child's Full Name]
- Date of Birth: [Child's Date of Birth]
3. Powers Granted
The agent shall have the authority to:
- Make decisions regarding the child's education.
- Authorize medical and dental treatment as needed.
- Handle the child's day-to-day care and welfare.
- Manage the child's extracurricular activities and events.
4. Duration of Authority
This Power of Attorney shall remain in effect until [Specify end date or event], unless revoked earlier by me in writing.
5. Revocation of Authority
I understand that I have the right to revoke this Power of Attorney at any time by providing written notice to the agent.
6. Acknowledgment
By signing below, I affirm that I am the parent/legal guardian of the child named above. I understand the rights I am granting and the responsibilities of the agent.
Signed this [Day] of [Month, Year].
_____________________________
[Parent/Guardian's Signature]
_____________________________
[Agent's Signature]
7. Notary Acknowledgment
State of Pennsylvania)
County of [County]
On this [Day] of [Month, Year], before me, a notary public, personally appeared [Parent/Guardian's Full Name] and [Agent's Full Name], known to me (or satisfactorily proven) to be the persons whose names are subscribed to this document, and they acknowledged that they executed it for the purposes therein contained.
_____________________________
[Notary Public's Signature]
My commission expires: [Date]