Ohio Power of Attorney for a Child
This document is intended to designate a Power of Attorney for a minor child in accordance with the laws of the state of Ohio.
Principal Information:
- Name of Parent/Guardian: _____________________________
- Address: _____________________________________________
- City: _____________________ State: ________ Zip Code: __________
- Phone Number: ______________________________________
Agent Information:
- Name of Agent: ______________________________________
- Address: _____________________________________________
- City: _____________________ State: ________ Zip Code: __________
- Phone Number: ______________________________________
Child Information:
- Name of Child: ______________________________________
- Date of Birth: ______________________________________
- Address (if different from Principal): ________________
This Power of Attorney allows the designated agent to make decisions regarding:
- Education
- Healthcare
- Travel
- Routine care and welfare of the child
Effective Date: This Power of Attorney shall become effective immediately and shall remain in effect until revoked in writing by the Principal.
Signature:
By signing below, the Principal affirms that they are of sound mind and are legally able to execute this Power of Attorney.
Signature of Parent/Guardian: ____________________________
Date: ________________
This document must be notarized for it to be valid.
Notary Public:
State of Ohio
County of ________________________
Subscribed and sworn before me this ______ day of ______________, 20__.
Signature of Notary: ______________________________________
My commission expires: ________________