California Power of Attorney for a Child
This document is intended to comply with the laws of the State of California regarding the appointment of a power of attorney for a child. This form must be completed and signed by the parent or legal guardian of the child.
Principal's Information:
- Full Name: ____________
- Address: ____________
- City, State, Zip: ____________
- Phone Number: ____________
Child's Information:
- Full Name: ____________
- Date of Birth: ____________
- Address: ____________
- City, State, Zip: ____________
Agent's Information:
- Full Name: ____________
- Address: ____________
- City, State, Zip: ____________
- Phone Number: ____________
Effective Date: This power of attorney will take effect on ____________ and will remain in effect until ____________, unless revoked earlier.
Powers Granted:
The agent shall have the authority to perform the following acts on behalf of the child:
- Make medical decisions.
- Handle education-related matters.
- Manage daily care and welfare.
Signature:
Signed this _____ day of ____________, 20____.
____________________
Signature of Parent/Guardian
Notarization:
State of California
County of ________________
Subscribed and sworn before me this _____ day of ____________, 20____.
____________________
Notary Public Signature
My commission expires: ____________