North Dakota Power of Attorney for a Child
This Power of Attorney form is executed in accordance with the laws of North Dakota. It designates an individual as the attorney-in-fact for the purpose of making decisions on behalf of a minor child.
Principal Information:
- Name of Parent/Guardian: ___________________________
- Address: _________________________________________
- City: _______________________ State: ____________ Zip: ___________
- Phone Number: ____________________________________
Child Information:
- Name of Child: ____________________________________
- Date of Birth: ____________________________________
- Address (if different from above): _________________
Attorney-in-Fact Information:
- Name of Attorney-in-Fact: _________________________
- Address: _________________________________________
- City: _______________________ State: ____________ Zip: ___________
- Phone Number: ____________________________________
Grant of Authority:
I, the undersigned, hereby appoint the above-named individual as my attorney-in-fact to act on my behalf in all matters relating to the care and custody of my child listed above. This authority includes, but is not limited to, the following:
- Making educational and medical decisions.
- Authorizing emergency medical treatment if necessary.
- Signing any necessary documents relating to my child's welfare.
- Coordinating with schools and healthcare providers.
Effective Date:
This Power of Attorney shall become effective on the date signed below and shall remain in effect until _______________________ (insert date or condition for revocation).
Signature:
By signing below, I affirm that I am authorized to grant these powers and that this document reflects my intent:
______________________________________
Signature of Parent/Guardian
______________________________________
Date
Witness Information:
Two witnesses are required to sign this document. Each witness must be an adult and cannot be related to the Principal or the Attorney-in-Fact.
- Witness 1: _____________________________
- Witness 2: _____________________________
Date: ______________________
This document should be kept in a safe place and a copy should be provided to the Attorney-in-Fact. It is advisable to review this document periodically to ensure it meets your current needs.