Minnesota Power of Attorney for a Child
This Power of Attorney for a Child authorizes another person (the attorney-in-fact) to make decisions concerning the child of the principal (the person granting the power) under the conditions stated herein. This document complies with the Minnesota Statutes, specifically under the sections concerning Delegations of Parental Authority. It is intended for temporary use and does not relinquish parental rights.
Principal Details:
Full Name: ____________________________________
Address: ______________________________________
City, State, Zip: _______________________________
Phone Number: ________________________________
Child Details:
Full Name: ____________________________________
Date of Birth: _________________________________
Attorney-in-Fact Details:
Full Name: ____________________________________
Address: ______________________________________
City, State, Zip: _______________________________
Phone Number: ________________________________
Terms and Conditions:
This Power of Attorney is effective upon the date of signature and remains in effect until ______________ (not to exceed one year from the date of signing, per Minnesota law) unless otherwise specified.
Within this period, the attorney-in-fact is authorized to make decisions and take action regarding the child’s:
- Healthcare
- Education
- Extracurricular activities
The principal retains the right to revoke this Power of Attorney at any time.
Signatures:
This Power of Attorney must be signed by the principal, attested by two witnesses, and notarized. Ensure that all parties are present during the signing to comply with Minnesota requirements.
Principal’s Signature: ___________________________ Date: _______________
Witness 1 Signature: ___________________________ Date: _______________
Witness 2 Signature: ___________________________ Date: _______________
Notary Public’s Signature: _______________________ Date: _______________
My commission expires: _________________________
Notary Acknowledgement:
State of Minnesota )
County of _______________ )
On this day, _______________ (date), before me, a notary public, personally appeared ______________________________________ (name of the principal), known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that they executed the same for the purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
________________________________________ (Notary Seal)
Notary Public Signature