Nebraska Power of Attorney for a Child
This document allows you to designate someone to make decisions on behalf of your child in Nebraska. This Power of Attorney is created in accordance with Nebraska state laws.
Principal Information:
- Name: _______________________________
- Address: _____________________________
- City, State, Zip: _____________________
- Phone Number: ________________________
Agent Information:
- Name: _______________________________
- Address: _____________________________
- City, State, Zip: _____________________
- Phone Number: ________________________
Child Information:
- Name: _______________________________
- Date of Birth: ________________________
Effective Date: This Power of Attorney is effective immediately and will remain in effect until revoked by the Principal.
Powers Granted: The Agent shall have the authority to:
- Make medical decisions for the child.
- Enroll the child in school or childcare programs.
- Make decisions regarding the child's education.
- Provide consent for participation in extracurricular activities.
Signature:
By signing below, I acknowledge that I am granting the above powers to the Agent.
Principal Signature: ___________________________
Date: ______________________________________
Witness Signature: ____________________________
Date: ______________________________________
Notary Public:
State of Nebraska, County of ________________
Subscribed and sworn before me on this _____ day of __________, 20__.
Notary Public Signature: ______________________
My Commission Expires: ______________________