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Arkansas Parental (Minor Children) Power of Attorney Form

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Arkansas Parental (Minor Children) Power of Attorney Form confers powers onto a trusted guardian to care for the principal’s children for a temporary period of time. This is a form that is good to have in the event you are going on vacation without your children and a relative is taking care of them. It can also be helpful if you are in the military and are going to be deployed. It will allow your agent to make financial and medical decisions on behalf of your children if the need arises and you can’t be reached.

Laws § 28-68-213

How to Write

1 – Select A PDF, ODT, or Word To Use

Three file types of this form are available to the right on this page. You may use any of these in a form friendly browser, that is up to date, to enter the information onscreen, download it to enter the information using the appropriate editing software, or print it then fill it out.

2 – Fill-In The Information

The first and second blank spaces, in the first paragraph, will seek to identify the Full Name of the Parent or Guardian and the Arkansas County where that individual is located (in that order). Provide this information.

The space preceding the words “[hereafter the “child”]” must provide the Full Name of the minor/child this document is concerned with.

Next, following the word “appoint,” enter the Full Name and Arkansas County of the individual being named to have authority over the child (as per this document).

Locate Item 6. Report the Name of the Parent/Guardian granting authority over the child on the first blank space, then report the individual who shall receive this authority (as per this document) on the second blank space.

3 – Revocation Option

If the Power this document bestows should terminate automatically, as of a certain date, this may be documented in Item 7. You must enter the name of the child/minor, on the blank space following the term “my child,” then enter the Date of Termination on the second blank line. This will effectively (automatically) revoke this document on that day. If this is not desired, this section may be left blank.

4 – Provide A Dated Signature

Locate the term “In Testimony Whereof,” then enter the Calendar Date this document is being signed. This must be done across the three blank spaces in a Day/Month/Year format

The Parent assigning authority to the Guardian named in this document must Sign his or her Name on the blank line labeled “Name of Parent”

The final area of this form may only be satisfied by the Notary Public who may document such facts as the parties attending the signing and the date of signing. This entity must also supply his or her credentials and seal


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