Special Power Of Attorney Form printable pdf download

SPECIAL POWER OF ATTORNEY

(IN LOCO PARENTIS-CHILD CARE)

PREAMBLE: THIS IS A POWER OF ATTORNEY PREPARED AND EXECUTED

PURSUANT TO TITLE 10. U.S.C., SECTION 1044B, BY A PERSON AUTHORIZED TO

RECEIVE LEGAL ASSISTANCE FROM THE MILITARY SERVICES. FEDERAL LAW

EXEMPTS THIS POWER OF ATTORNEY FROM ANY REQUIREMENTS OF FORM,

SUBSTANCE, FORMALITY, OR RECORDING THAT IS PRESCRIBED FOR POWERS OF

ATTORNEY BY THE LAWS OF ANY STATE, COMMONWEALTH, TERRITORY, DISTRICT,

OR POSSESSION OF THE UNITED STATES. FEDERAL LAW SPECIFIES THAT THIS

POWER OF ATTORNEY SHALL BE GIVEN THE SAME LEGAL EFFECT AS A POWER OF

ATTORNEY PREPARED AND EXECUTED IN ACCORDANCE WITH THE LAWS OF THE

JURISDICTION WHERE IT IS PRESENTED.

KNOW ALL MEN BY THESE PRESENTS: That I, ______________________________,

currently residing at: _________________________________________________, have this day

appointed ______________________________________, currently residing at

_________________________________________________, to serve as my true and lawful

attorney(s)-in-fact, GIVING AND GRANTING unto my said attorney(s) full power to:

1. Act as legal guardian of my child(ren) herein named, including more specifically in

loco parentis, to accomplish and all acts necessary to enroll, register, and take care of any

and all matters pertaining to college matriculation and attendance, and to execute any

parental consent forms for said child(ren), and to execute all necessary documents,

instruments or papers and perform all acts necessary to accomplish the foregoing.

2. Authorize any and all medical, dental, and hospital care and treatment, including

major surgery, deemed necessary by a duly authorized and licensed physician for the health

and well-being of my child(ren) herein named. In caring for and maintaining said

child(ren) my attorney(s)-in-fact are authorized to perform those parental functions and

make those decisions as would I, the legal parent and guardian if I were present, and to

execute all

necessary documents, instruments or papers and perform all acts necessary to

accomplish the foregoing.

FULL NAME OF CHILD

BIRTH DATE

RELATIONSHIP

_______________________________________________________________

FURTHER, I do authorize my attorney(s) to perform all necessary acts in the execution of the

aforesaid authorization with the same validity as I could effect if personally present. I further

declare that any act or thing lawfully done hereunder by my said attorney(s) shall be binding on

myself and my heirs; legal and personal representatives, and assigns whether the same shall been

done either before or after my death, or other revocation of the instrument, unless and until

reliable intelligence or notice thereof shall have been received by my said attorneys.

PROVIDED, however, that all actions taken hereunder for me or for my account shall be

transacted in my name, and that all endorsements and instruments executed by my said

attorney(s) for the purpose of carrying out the foregoing powers shall contain my name, followed

by that of my said attorney(s) and the designation "attorney(s)-in-fact."

Special Power Of Attorney Form