Arizona Power of Attorney for a Child
This document serves as a Power of Attorney for a Child in accordance with Arizona state laws. It grants authority to an individual to make decisions on behalf of a minor child.
Principal Information:
- Full Name of Parent/Guardian: ____________________________
- Address: ____________________________
- City: ____________________________
- State: Arizona
- Zip Code: ____________________________
- Phone Number: ____________________________
Agent Information:
- Full Name of Agent: ____________________________
- Address: ____________________________
- City: ____________________________
- State: ____________________________
- Zip Code: ____________________________
- Phone Number: ____________________________
Child Information:
- Full Name of Child: ____________________________
- Date of Birth: ____________________________
- Address: ____________________________
- City: ____________________________
- State: Arizona
- Zip Code: ____________________________
This Power of Attorney grants the Agent the authority to:
- Make medical decisions for the child.
- Make educational decisions for the child.
- Authorize the child’s participation in extracurricular activities.
- Provide for the child’s general welfare.
Effective Date: This Power of Attorney shall become effective on ____________________________ and shall remain in effect until ____________________________.
Signature of Parent/Guardian: ____________________________
Date: ____________________________
Notary Acknowledgment:
State of Arizona, County of ____________________________
On this ______ day of __________, 20__, before me, a Notary Public, personally appeared ____________________________, known to me to be the person whose name is subscribed to the within instrument, and acknowledged that he/she executed the same for the purposes therein contained.
Witness my hand and official seal.
______________________________
Notary Public
My commission expires: ____________________________