North Dakota Power of Attorney for a Child
This Power of Attorney document empowers an individual to make decisions regarding a minor child in North Dakota, as outlined in the North Dakota Century Code, Section 30.1-27 (Uniform Power of Attorney Act). Carefully complete the details below to establish a legal arrangement that temporarily delegates parental authority over a child to another person.
Section 1: Child Information
Full Name of Child: ___________________________
Date of Birth: ________________________________
Current Address: ______________________________
_____________________________________________
Section 2: Parent/Guardian Information
Full Name of Parent/Guardian: ____________________
Relationship to Child: __________________________
Contact Number: _______________________________
Email Address: ________________________________
Current Address: ______________________________
_____________________________________________
Section 3: Attorney-in-Fact Information
Full Name of Attorney-in-Fact: ___________________
Relationship to Child: __________________________
Contact Number: _______________________________
Email Address: ________________________________
Current Address: ______________________________
_____________________________________________
Section 4: Authority Granted
This Power of Attorney grants the Attorney-in-Fact the authority to act on behalf of the child in the following areas (check all that apply):
- ____ Education decisions
- ____ Medical decisions
- ____ Travel arrangements
- ____ Other: ___________________________________
Section 5: Term
Start Date of Power of Attorney: ___________________
End Date of Power of Attorney: ____________________
If no End Date is specified, this Power of Attorney shall remain effective for a period of six (6) months, as per North Dakota state law.
Section 6: Acknowledgment
This document, once completed and signed by all parties, including the signature of two (2) witnesses or a notary acknowledgment, will serve as the legal Power of Attorney for the child named above in the State of North Dakota.
Section 7: Signatures
Parent/Guardian Signature: ___________________________ Date: _________
Attorney-in-Fact Signature: ___________________________ Date: _________
Witness 1 Signature: _________________________________ Date: _________
Witness 2 Signature: _________________________________ Date: _________
Or
Notary Public Acknowledgment
State of North Dakota )
County of ____________ )
On this day, _________ of _________, 20____, before me, a notary public, personally appeared ____________________________,
known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that they executed the same for the purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
Notary Public Signature: ____________________________
My commission expires: _____________________________