New Jersey Power of Attorney for a Child
This document serves as a Power of Attorney for a child, allowing the designated agent to make decisions on behalf of the child in accordance with New Jersey law.
Child's Information:
- Name: ______________________________
- Date of Birth: ______________________
-
Parent(s) or Legal Guardian(s) Information:
- Name: ______________________________
- Name: ______________________________
- Address: ___________________________
- Phone Number: ______________________
Designation of Agent:
I/We, the undersigned Parent(s) or Legal Guardian(s), hereby appoint the following individual as the Agent for my/our child:
- Name of Agent: ______________________
- Address: ____________________________
- Phone Number: ______________________
Grant of Authority:
The Agent shall have the authority to make decisions related to the care and supervision of the child, including but not limited to:
- Medical and dental care.
- Educational decisions.
- Travel arrangements.
- Access to records.
Effective Date:
This Power of Attorney is effective immediately and shall remain in effect until __________ (specify end date) unless revoked by the Parent(s) or Legal Guardian(s) in writing.
Signatures:
By signing below, I/we affirm that I/we have the authority to grant this Power of Attorney and that the information provided is accurate to the best of my/our knowledge.
___________________________ ___________________________
Parent/Guardian Signature Date
___________________________ ___________________________
Parent/Guardian Signature Date
Notary Acknowledgment:
State of New Jersey
County of ______________________
On this _____ day of ____________, 20__, before me, a Notary Public, personally appeared ____________ and ____________, known to me (or satisfactorily proven) to be the persons whose names are subscribed to this document, and acknowledged that they executed the same for the purposes therein contained.
______________________________
Notary Public Signature
My commission expires: _______________