Letter Of Guardianship Form

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LETTER OF GUARDIANSHIP
BEFORE ME, the undersigned authority, personally came and appeared:
__________________________________________who did say
(Parent Name)
that they are the parent of ______________________________who is a minor. They do
(Child’s Name)
hereby give permission to _____________________________commencing on
(Guardian Name)
_________________________and ending __________________________
(Beginning Date)
(Ending Date)
to have full rights of guardianship, including such matters as to authorize medical treatment of
any necessary nature, sign documents of any type, obtain lodging and do all things that I as a
parent and/or legal guardian may do.
___________________________
Parent Signature
MUST BE NOTARIZED
STATE OF:
____________________
COUNTY OF:
____________________
Before me, a Notary Public, in and for said County and State, personally appeared ___________________________
who acknowledged the execution of the foregoing, and who, having been duly sworn, stated that the representations therein contained
are true.
Witness my hand and Notarial Seal this _____ day of________________________ 20___ .
__________________________________
Signature
__________________________________
Printed
__________________________________
My Commission Expires
LETTER OF GUARDIANSHIP – 02.17.2016
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