Ohio Power of Attorney for a Child
This Power of Attorney document is created under the laws of the state of Ohio. It allows a designated individual to make decisions on behalf of a child when necessary. Please complete the necessary information in the blanks provided.
Principal (Parent/Guardian) Information:
Name: ________________________________________
Address: ______________________________________
City, State, Zip: ______________________________
Phone Number: _________________________________
Agent (Authorized Individual) Information:
Name: ________________________________________
Address: ______________________________________
City, State, Zip: ______________________________
Phone Number: _________________________________
Child's Information:
Name: ________________________________________
Address (if different from Principal): ________________________________________
City, State, Zip: ______________________________
Date of Birth: _________________________________
This Power of Attorney grants the Agent authority over the following matters:
- Medical decisions
- Educational decisions
- Emergency decisions
- Other: ______________________________________
Effective Date:
This Power of Attorney shall be effective starting on: _______________.
Termination:
This Power of Attorney will remain in effect until:
- Revoked by the Principal.
- The child reaches the age of 18.
- A date specified: ________________.
Signature:
By signing below, the Principal acknowledges that they understand the nature of this Power of Attorney and voluntarily grant authority to the Agent.
Principal’s Signature: ________________________________
Date: ___________________
Agent’s Signature (optional): _________________________
Date: ___________________
This document should be notarized to ensure its validity:
Notary Public Signature: _____________________________
Date: ___________________
It is advisable to consult with a legal professional for further guidance to ensure compliance with Ohio state laws.