North Carolina Power of Attorney for a Child
This document serves as a Power of Attorney for a Child in accordance with North Carolina state laws. It allows a parent or legal guardian to designate another individual to make decisions on behalf of their child. Please fill in the blanks with the appropriate information.
Principal Information:
- Full Name of Parent/Guardian: ______________________________
- Address: _________________________________________________
- Phone Number: ____________________________________________
Agent Information:
- Full Name of Agent: _______________________________________
- Address: _________________________________________________
- Phone Number: ____________________________________________
Child Information:
- Full Name of Child: ________________________________________
- Date of Birth: ____________________________________________
Effective Date: This Power of Attorney will become effective on: ________________________.
Duration: This Power of Attorney will remain in effect until: ________________________.
Powers Granted: The agent shall have the authority to make decisions regarding the following:
- Medical care and treatment.
- Education decisions.
- Travel arrangements.
- Other: ____________________________________________.
Signatures:
By signing below, I affirm that I am the parent or legal guardian of the child named above and that I am granting these powers to the designated agent.
______________________________
Signature of Parent/Guardian
Date: ________________________
______________________________
Signature of Agent
Date: ________________________
Notary Public:
State of North Carolina
County of ____________________
Subscribed and sworn before me this _____ day of ____________, 20__.
______________________________
Notary Public Signature
My Commission Expires: ______________________