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Indiana Power of Attorney For Minor Child Form

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Indiana Power of Attorney For Minor Child Form is a document that allows you to appoint someone to make decisions on behalf of your children, including medical and educational decisions for up to twelve (12) months. If you are planning on being away for an extended time or you anticipate a long recuperation from an illness and need to know that someone is caring for your children, this may be a useful form to have in place.

Laws – § 29-3-9-1

How to Write

1 – Consolidate The Identifying Information For All Parties Then Open The Form On This Page

Several parties will be directly involved in this paperwork. When reporting the Identity of one of these parties make sure to do so accurately. When you have all your reference material open the form available below the image on the right.

2 – Identify Each Parent/Guardian, Minor/Child, and Intended Representative/Guardian

Enter the First Name, Middle Name, and Last Name of each Parent or Legal Guardian who is granting Authority over the Minor or Child on the first blank line in this document.

On the second blank line of this document, enter the exact Name of each Minor or Child over whom guardianship is being delivered.

Finally, on the third blank line enter the First, Middle, and Last Name of the Representative who will assume the Guardian role over the minor as a result of this form.

The fourth blank line, just before “Indiana, as representative…” requires the Physical Street Address where the Representative resides entered.

3 – The Guardian’s Effective Period Of Representation

Normally, this document will go into effect upon signing. It will be necessary to define how long it stays in Effect. That is, how long may the intended Guardian act as a Guardian. On the blank line in the statement beginning with “This appointment shall be effective…,” enter the Number of Days from the Date of Signing when this Power will remain in effect for.

4 – Signing And Notarizing This Document

The Parent/Current Guardian must enter the Date of Signing on the last line of this form (after the words “…signed this document this”) by recording the Day, Month, and Year of Signing.

The Parent/Current Guardian must sign this document as directed by the Notary Public. Additionally, the Parent/Current Guardian’s Contact Information must be filled in with his or her Mailing Address, Emergency Telephone Number, and E-Mail Address.


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