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Temporary Delegation Of Parental Powers

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TEMPORARY DELEGATION OF PARENTAL POWERS

I,_____________________________ of _____________________________,

(your full name)

(city where you reside)

Nebraska, do make and appoint _______________________________________ of

(full name of person being appointed)

_____________________________________________________, to act for me and in

(address, city and state where person being appointed resides)

my name to exercise all my powers regarding the care, custody and property of

___________________________________, born ____________________________,

(child’s full name)

(child’s date of birth)

except my power to consent to marriage and adoption of the child. I hereby give

___________________________________ full authority and power to do everything

(full name of person being appointed)

necessary to be done, as fully as I could or might do if personally present, for a period

not exceeding six months beyond this date. I confirm and ratify all lawful acts done, or

caused to be done by __________________________________ acting under this

(full name of person being appointed)

Delegation of Powers regarding the care, custody and property of my child. This

Delegation of Parental Powers may be revoked by me at any time before the expiration

of this six-month period by written notice to ______________________________ at the

(full name of person being appointed)

address above.

WITNESS my hand this ____day of _____________________, 20___.

_____________________________

(your signature)

ACKNOWLEDGED before me this____day of ____________, 20___.

_____________________________

Notary Public

Temporary Delegation of Parental Powers, DC 6:10(1)

Temporary Delegation Of Parental Powers

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