Navpers Family Care Plan Arrangements Page 3
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3FAMILY CARE PLAN ARRANGEMENTS
NAVPERS 1740/7 (Rev. 02-2011)
Supporting Directive OPNAVINST 1740.4
4. EDUCATIONAL FACILITIES LOCATION
:
(CONTINUED)
POWER OF ATTORNEY
COURT ORDER FOR CAREGIVER
ADDITIONAL COMMENTS:
5. LEGAL:
PROVIDED COPIES OF EXISTING COURT ORDERS FOR CUSTODY/VISITATION/SUPPORT/OTHER
DISCUSSED PENDING COURT CASES FOR CUSTODY/VISITATION/SUPPORT/OTHER
NAME OF COURT:
LOCATION:
PENDING CIVIL MATTERS FOR OTHER ISSUES:
PROVIDED LOCATION OF LEGAL DOCUMENTS
(WILLS, POWER OF ATTORNEY, COURT ORDERS)
IDENTITY OF PERSONS/AGENTS TO MANAGE YOUR AFFAIRS IN THE EVENT OF INCAPACITY
NAME:
PHONE:
ADDRESS:
E-MAIL:
LEGAL POINTS OF CONTACT FOR THE CAREGIVER
ATTORNEY:
PHONE:
LEGAL SERVICE OFFICE:
PHONE:
EXPLAINED WHAT THE CAREGIVER SHOULD DO IN THE EVENT THEY ARE NO LONGER ABLE TO CARE FOR FAMILY MEMBERS
ADDITIONAL COMMENTS:
7. MEMBER'S SIGNATURE:
6. TYPED OR PRINTED NAME OF MEMBER:
8. DATE
(YYYYMMDD):
Page 3 of 3
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