Mississippi Power of Attorney for a Child
This Power of Attorney is created in accordance with the laws of the State of Mississippi.
Principal Information:
- Name: ________________________________
- Address: ________________________________
- City, State, Zip: ________________________________
- Phone Number: ________________________________
Child Information:
- Name: ________________________________
- Date of Birth: ________________________________
- Address: ________________________________
- City, State, Zip: ________________________________
Agent Information:
- Name: ________________________________
- Address: ________________________________
- City, State, Zip: ________________________________
- Phone Number: ________________________________
Effective Date: This Power of Attorney shall become effective on the following date: ________________________________.
Duration: This Power of Attorney shall remain in effect until: ________________________________.
Powers Granted: The Agent shall have the authority to:
- Make decisions regarding the child's education.
- Authorize medical treatment for the child.
- Manage the child's financial matters.
- Provide for the child's welfare and safety.
Signature:
By signing below, I affirm that I am the Principal and that I am granting this Power of Attorney voluntarily.
Principal Signature: ________________________________
Date: ________________________________
Witness Information:
- Name: ________________________________
- Address: ________________________________
- Signature: ________________________________
- Date: ________________________________
Notary Public:
State of Mississippi
County of ________________________________
On this ____ day of ____________, 20___, before me, a Notary Public, personally appeared ________________________________, known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged that he/she executed the same.
Notary Signature: ________________________________
My commission expires: ________________________________