New Jersey Power of Attorney for a Child
This Power of Attorney document is created in accordance with New Jersey state laws. It grants authority to an individual to care for and make decisions on behalf of a minor child.
Principal Information:
- Name of Principal: _______________________
- Address of Principal: _____________________
- Phone Number of Principal: ________________
- Email of Principal: _______________________
- Relationship to Child: _______________________
Child Information:
- Name of Child: __________________________
- Date of Birth of Child: ___________________
Agent Information:
- Name of Agent: __________________________
- Address of Agent: ________________________
- Phone Number of Agent: ___________________
- Email of Agent: __________________________
Authority Granted:
The Agent is granted the authority to:
- Make medical and healthcare decisions for the child.
- Enroll the child in school and participate in educational decisions.
- Provide for the child's daily needs.
- Make decisions regarding the child's religious upbringing.
- Authorize participation in extracurricular activities.
Effective Date:
This Power of Attorney shall become effective on the following date: _____________.
Duration: This Power of Attorney shall remain in effect until _____________ or until revoked in writing.
Signatures:
By signing below, the Principal acknowledges that they are granting authority to the Agent as outlined above.
- Signature of Principal: ______________________ Date: _____________
- Signature of Agent: _________________________ Date: _____________
Witnesses:
- Name of Witness 1: ______________________ Signature: _______________ Date: _____________
- Name of Witness 2: ______________________ Signature: _______________ Date: _____________
Notarization:
State of New Jersey, County of _______________
Subscribed and sworn before me, the undersigned notary public, on this ____ day of ________________, 20__.
Notary Public Signature: ___________________________
My Commission Expires: ____________________________