Georgia Power Of Attorney Form For The Care Of A Minor Child (Page 2 of 5) in pdf

Georgia Power Of Attorney Form For The Care Of A Minor Child Page 2

GOVERNMENT AUTHORITY THAT IS CHARGED WITH ASSURING PROPER

CARE OF SUCH MINOR CHILD.

(6)

THIS POWER OF ATTORNEY MAY BE REVOKED IN WRITING BY ANY

AUTHORIZING PARENT. IF THE POWER OF ATTORNEY IS REVOKED, THE

REVOKING PARENT SHALL NOTIFY THE AGENT GRANDPARENT, SCHOOL,

HEALTH CARE PROVIDERS, AND OTHERS KNOWN TO THE PARENT TO

HAVE RELIED UPON SUCH POWER OF ATTORNEY.

(7)

IF THERE IS ANYTHING ABOUT THIS FORM THAT YOU DO NOT

UNDERSTAND, YOU SHOULD ASK A LAWYER TO EXPLAIN IT TO YOU.

POWER OF ATTORNEY FOR THE CARE OF A MINOR CHILD

made this ___________ day of _________________, ___________.

(1)

(A)

I, ____________________________(insert name and address of parent or

parents),

herby

appoint_____________________________________________________

(insert name and address of grandparent to be names as agent) as attorney in fact

(the agent grandparent) for my child ____________________________________

(insert name of child) to act for me and in my name in any way that I could act in

person.

(B)

I hereby certify that the agent grandparent named herein is the (place a

check mark beside the appropriate description):

_________

Biological grandparent;

_________

Step grandparent;

_________

Biological great-grandparent; or

_________

Step great-grandparent.

(2)

The agent grandparent may:

Georgia Power Of Attorney Form For The Care Of A Minor Child Page 2