Indiana Power of Attorney for a Child
This Power of Attorney for a Child document is designed in accordance with the Indiana Code 29-3-9, allowing a parent or guardian to grant certain powers regarding the care and custody of a child or children to a designated agent. This authorization includes but is not limited to decisions related to education, healthcare, and other significant areas affecting the child's well-being.
1. Parties Involved
Parent/Guardian's Full Name: ___________________________
Parent/Guardian's Address: _____________________________
Child/Children's Name(s) and Date(s) of Birth:
- Name: _______________, Date of Birth: ___________
- Name: _______________, Date of Birth: ___________
Designated Agent's Full Name: _________________________
Designated Agent's Address: __________________________
2. Powers Granted
The parent/guardian hereby grants the designated agent the following powers:
- Medical decisions including but not limited to treatment options and emergency care.
- Educational decisions including but not limited to school enrollment and participation in school activities.
- Authority to travel with the child/children within and outside of the state of Indiana.
- Permission to handle matters related to the child/children's property, if any.
3. Term
This Power of Attorney shall be effective from __________ (start date) to __________ (end date), unless it is revoked earlier by the parent or guardian in writing.
4. Signature
In agreement to the terms outlined in this document, the undersigned parties have set their hands:
Parent/Guardian's Signature: ______________________ Date: ______
Designated Agent's Signature: _____________________ Date: ______
This document was signed in the presence of:
Witness 1's Signature: ___________________________ Date: ______
Witness 2's Signature: ___________________________ Date: ______
5. Notarization
To add legal weight and help prevent future challenges, it's recommended that this document be notarized. A notary public can witness the signatures and stamp the document accordingly.
Notary Public's Signature: _________________________ Date: ______
My commission expires: _________________________
Note: The powers granted by this document do not include the ability to consent to marriage or adoption of the child/children. It is also advisable to consult with a legal professional to ensure all Indiana state requirements are met and to address any specific needs or concerns.