Nebraska Power of Attorney for a Child
This Power of Attorney for a Child template is designed for use in the State of Nebraska. It grants authority to an appointed individual to make decisions and take certain actions regarding the care of a minor child. By executing this document, the parent(s) or legal guardian(s) agree to delegate their parental or legal rights in accordance with the Nebraska Uniform Power of Attorney Act.
Instructions: Fill in the relevant information in the spaces provided. Ensure all provided information is accurate and complete.
1. Designation of Agent
I/We, _________________________ [Parent(s)/Legal Guardian(s) Name(s)], residing at ______________________________ [Address], hereby appoint _________________________ [Agent's Name] of ______________________________ [Agent's Address], as my/our true and lawful attorney-in-fact to act for my/our child, _________________ [Child's Name], in my/our name and behalf.
2. Child's Information
Name: _________________________
Date of Birth: __________________
Place of Birth: _________________
3. Agent’s Authority
This Power of Attorney shall grant the following powers to the appointed agent:
- Make educational decisions, including but not limited to, determining the school the child shall attend and participating in all school-related meetings and activities.
- Make healthcare decisions, including the power to consent to medical, surgical, and dental treatments.
- Make decisions regarding the child’s participation in extracurricular activities, including sports and clubs.
- Authorize travel, domestically and internationally.
- Take any other action necessary for the care, protection, and welfare of the child.
4. Term
This Power of Attorney shall become effective on ______________ [Effective Date] and, unless sooner revoked, shall remain in effect until ______________ [End Date] or unless otherwise provided by law.
5. Signature and Acknowledgment
This Power of Attorney must be signed and dated by the parent(s) or legal guardian(s), the appointed agent, and witnessed by two adults or a Notary Public.
Parent(s)/Legal Guardian(s) Signature: ___________________________
Date: ___________________________
Agent's Signature: ___________________________
Date: ___________________________
Witness/Notary Public Signature: ___________________________
Date: ___________________________
6. Revocation
The parent(s) or legal guardian(s) retain the right to revoke this Power of Attorney at any time by providing written notice to the appointed agent and any third party relying on this document.