Indiana Power of Attorney for a Child
This Power of Attorney is created in accordance with Indiana state laws and allows a parent or legal guardian to designate another individual to make decisions on behalf of their child.
Principal Information:
- Name of Parent/Guardian: ________________________
- Address: _______________________________________
- City, State, Zip: _______________________________
- Phone Number: _________________________________
Agent Information:
- Name of Agent: ________________________________
- Address: _______________________________________
- City, State, Zip: _______________________________
- Phone Number: _________________________________
Child Information:
- Name of Child: _________________________________
- Date of Birth: _________________________________
- Address: _______________________________________
Powers Granted:
The Agent shall have the authority to make decisions regarding the following:
- Medical care and treatment.
- Education decisions.
- Travel arrangements.
- Other matters concerning the welfare of the child.
This Power of Attorney shall commence on the date signed and shall remain in effect until revoked in writing or until the child reaches the age of majority.
Signatures:
By signing below, the Principal grants the above powers to the Agent.
______________________________
Signature of Parent/Guardian
Date: ________________________
______________________________
Signature of Agent
Date: ________________________
Notary Public:
State of Indiana
County of ______________________
Subscribed and sworn to before me this ____ day of __________, 20__.
______________________________
Notary Public Signature
My Commission Expires: ________________________