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Power of Attorney for the Care of a Minor Child

(Pursuant to Georgia Code Title 19, Chapter 9, Article 4)
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(Pursuant to Georgia Code Title 19, Chapter 9, Article 4)

THIS DOCUMENT DOES NOT AUTHORIZE THE ATTORNEY-IN-FACT TO CONSENT TO THE MARRIAGE OR ADOPTION OF THE MINOR CHILD(REN).

  1. Parties Involved:

Grantor/Parent(s):
Full Name: ______________________________
Address: ________________________________
City/State/Zip: ___________________________
Phone: _________________________________

Attorney-in-Fact (Caregiver):
Full Name: ______________________________
Address: ________________________________
City/State/Zip: ___________________________
Phone: _________________________________

Child(ren):

  • Full Name: _____________________________
    Date of Birth: __________________________
  • Full Name: _____________________________
    Date of Birth: __________________________
  1. Authority Granted:

I/We, the undersigned parent(s), hereby appoint the above-listed Attorney-in-Fact to act in my/our place and stead to make all decisions concerning the care, custody, and control of the minor child(ren) listed above, including but not limited to:

  • Enrolling the child(ren) in school or extracurricular activities.
  • Seeking medical, dental, or psychological treatment.
  • Providing food, clothing, and shelter.
  • Managing day-to-day welfare and safety.
  1. Duration of Authority:

This Power of Attorney is effective on ______________ (start date) and shall remain in effect until ______________ (end date, no more than one year), unless terminated earlier in writing or extended in compliance with Georgia law.

 

  1. Revocation:

I/We retain the right to revoke this Power of Attorney at any time by providing written notice to the Attorney-in-Fact.

  1. Limitations:

This Power of Attorney does not grant the Attorney-in-Fact the authority to:

  • Consent to the marriage or adoption of the child(ren).
  • Transfer permanent custody of the child(ren).
  1. Signatures and Acknowledgments:

Grantor/Parent(s):
Signature: ______________________________
Printed Name: __________________________
Date: _________________________________

Attorney-in-Fact (Caregiver):
Signature: ______________________________
Printed Name: __________________________
Date: _________________________________

  1. Witness and Notary Acknowledgment:

State of Georgia
County of ______________

Subscribed and sworn to before me this ____ day of _______, 20.

Witness:
Signature: ______________________________
Printed Name: __________________________
Address: _______________________________

Notary Public:
Signature: ______________________________
My Commission Expires: _________________