Laws
Expiration – This document’s validity will not exceed 180 days unless the parent or guardian is on active military duty and deployed to a foreign nation, in which case, the delegation would be effective until the 31st day after the end of the deployment.[2]
Sample
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I, [PARENT / GUARDIAN NAME], of [PARENT/GUARDIAN CITY/TOWN, STATE/PROVINCE, COUNTRY], do hereby make, constitute and appoint [ATTORNEY-IN-FACT NAME], of [ATTORNEY-IN-FACT CITY/TOWN, STATE/PROVINCE, COUNTRY], as my true and lawful attorney in fact for me and in my name, place and stead. I give unto said attorney full power to do and perform all duties which I have as a custodial parent and legal guardian of [MINOR CHILD NAME], whose date of birth is [MM/DD/YYYY], including, but not limited to, making necessary decisions concerning the health (including the authorization of medical treatment), education (including enrolling in school), property, custody and general care of said child. In accordance with Michigan Compiled Laws § 700.5103, this delegation does not include the power to consent to marriage and/or adoption. This delegation of power will end six (6) months after the date that I affix my signature below, unless revoked by me in writing before that date.Parent/Guardian Signature: _______________________ Date: ______________
Print Name: _______________________Witness Signature: _______________________ Date: ______________
Print Name: _______________________
Witness Signature: _______________________ Date: ______________
Print Name: _______________________
Acknowledged before me this ____ day of _____, 20___.
Notary Public Signature: _____________________ County ____________
Commission Expires: _______________________