Updated April 27, 2022
A Nebraska delegation of parental (minor child) power of attorney form is a document that parent(s) can use to appoint someone to care for their child(ren) temporarily. This declares the temporary caretaker has the parental approval required to make medical and educational decisions on behalf of the parent’s child. There are times when it becomes necessary to place your child in the hands of another while you deal with military deployment, a serious health issue, or are going to be away for an extended period of time. This gives your trusted caretaker the ability to make decisions in the event you can’t be reached.
The document is valid for a period of six (6) months from the date of commencement.
Laws – § 30-2604
How to Write
1 – Download The Document On This Page Then Fill It Out To Designate Parental Power
The form available through the buttons on this page (below the image) will need to be opened then downloaded. Once you have read through it, you may enter the information it requires onscreen or directly on a printed copy. It is recommended that you keep a copy of this document for your records.
2 – Enter Information Directly Into The Delegation Of Power Statement
This page will provide the wording you must use to delegate Guardian Powers over a Child or a Minor (in your care) to a Guardian Attorney-in-Fact that you name to care or the Child or Minor. It will, however, require some information entered in specific areas so that it may apply to the current task.
The first line will have two blank spaces. Each will be labeled with the information it requires. Fill in the full Name of the Parent who is delegating Guardian Authority on the blank space labeled “Your Full Name.” 
Then on the blank space labeled “City Where You Reside,” record the name of the City where the Principal currently lives.
The next line will also have a blank space. Here, on the space labeled “Full Name Of Person Being Appointed,” fill in the Legal Name of the Attorney-in-Fact being appointed with Guardian Powers. 
The blank space labeled “Address, City, And State Where Person Being Appointed Resides” must have the Physical Address of the Guardian Attorney-in-Fact documented. This must be a Physical Home Address and may not be a P.O. Box. 
Report the Full Name of the Child/Minor who the Guardian will watch over on the blank space (labeled “Child’s Full Name”) following the words “…Regarding The Care, Custody, And Property Of.” 
Then, enter the Child’s Birth Date on the blank space labeled “Child’s Date Of Birth” (following the word “…Born.”
The Name of the Attorney-in-Fact will need to be re-entered thrice more in this paragraph. When doing so, make sure to record it precisely as it appears above. Fill in the Guardian Attorney-in-Fact’s Full Name on the blank space labeled “Full Name Of Person Being Appointed” following the term “I Hereby Give.”
Input the Guardian Attorney-in-Fact’s Name on the space following the term “…Caused To Be Done By”
Record the Guardian Attorney-in-Fact’s Name on the space after the words “…Six-Month Period BY Written Notice To.”
3 – Sign This Form To Appoint The Authority Defined To The Attorney-in-Fact Named
When the Principal is ready to execute this document, he or she must report the Date of Signature on in the statement beginning with the words “Witness My Hand This” Then, sign his or her Name on the blank space labeled “Your Signature.”
The Notary Public will use the area beginning with the words “Acknowledged Before Me…” to notarize this form. Note: The Date of Signature the Principal entered and the Notarization Date the Notary Public is reporting must be the same Date.