Indiana Power of Attorney for a Child
This Power of Attorney for a Child document is prepared in accordance with the laws of the State of Indiana. It is designed to temporarily grant certain parental rights and responsibilities to an individual, herein referred to as the Attorney-in-Fact, by the child's parent or legal guardian.
NOTICE: The powers granted by this document include the ability to make decisions on behalf of the child regarding education, healthcare, and general welfare unless specified otherwise. This document does not grant the Attorney-in-Fact the authority to consent to marriage or adoption of the child. Individuals seeking to utilize this form should first consult with a legal professional.
Principal Information (Parent/Legal Guardian):
- Full Name: ________________________________
- Address: ________________________________
- City, State, ZIP: ________________________________
- Contact Number: ________________________________
Child Information:
- Full Name: ________________________________
- Date of Birth: ________________________________
- Address (if different from Principal): ________________________________
Attorney-in-Fact Information:
- Full Name: ________________________________
- Relationship to Child: ________________________________
- Address: ________________________________
- Contact Number: ________________________________
Term of Power of Attorney:
This Power of Attorney shall commence on ____/____/____ and shall remain in effect until ____/____/____, unless terminated earlier by the Principal or by operation of law.
Powers Granted:
The Attorney-in-Fact shall have the authority to act in the Principal's stead in relation to the child, including but not limited to:
- Enrollment in and withdrawal from educational institutions and programs
- Authorization of medical, dental, and mental health treatments and procedures
- Participation in extracurricular activities
- Authorization of travel
- Making decisions regarding day-to-day care and discipline
Limitations on Power of Attorney:
It is expressly forbidden for the Attorney-in-Fact to consent to the marriage or adoption of the child. Furthermore, this document does not provide the Attorney-in-Fact with the authority to override decisions made by the child's other parent or legal guardian, where applicable.
Signatures:
This document must be signed by the following parties in the presence of a notary public:
- Principal (Parent/Legal Guardian)
- Attorney-in-Fact
______________________________ Date: ____/____/____
Principal's Signature
______________________________ Date: ____/____/____
Attorney-in-Fact's Signature
Notary Public:
This document was acknowledged before me on this ____ day of ____________, 20____, by ________________________________, as Principal, and ________________________________, as Attorney-in-Fact.
______________________________ Date: ____/____/____
Notary's Signature
Commission Expires: __________________