Power Of Attorney Delegating Parental Powers - Ada County

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POWER OF ATTORNEY DELEGATING PARENTAL POWERS
To a grandparent, sibling of parent or sibling of the minor child/ren
__________________________________________________________ , a parent or guardian
Typewritten or Printed Name of Parent or Guardian
of the minor child/ren [name(s) and birthdate(s)]
_____________________________________________ , born
_____________________________________________ , born
_____________________________________________ , born
pursuant to Idaho Code Section 15-5-104, delegates his/her parental powers to (
)
name(s)
____________________________________________________________________________
of
_______________________________________________________________
(current address)
____________________________________________________________________________ .
who is a [ ] grandparent, or [ ] sibling of a parent , or [ ] sibling of the above minor child/ren.
This delegation of power includes all powers regarding the care, custody, and property of the
minor child/ren except the power to consent to marriage or adoption of the minor child/ren.
This power expressly allows my delegate to travel outside the United States with the minor
child/ren. [ ]Yes
[ ]No
This power of attorney shall remain in full force and effect for [ ] three (3) years, unless earlier
revoked by me in writing; OR [ ] until _____________________________________________
___________________________________________________________________________
___________________________________________________________________________,
unless earlier revoked by me in writing.
___________________________________
Signature of Parent or Guardian
____________________________________________________________________________
Optional Notarization
STATE OF ______________ )
: ss
County of _______________ )
On the ______ day of ______________________, 20_____, before me, a Notary Public,
personally appeared ___________________________________________________________,
known or identified to me to be the person whose name is subscribed to the within or foregoing
instrument, and acknowledged to me that s/he executed the same.
___________________________________
Notary Public for _____________________
Residing at _________________________
Commission expires: _________________
PARENTAL POWER OF ATTORNEY - RELATIVE
CAO P 2
Effective 10/20/2003

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