Arkansas Power of Attorney for a Child
This Power of Attorney is executed in accordance with the laws of the State of Arkansas.
Principal Information:
- Name: __________________________
- Address: ________________________
- City: ___________________________
- State: __________________________
- Zip Code: _______________________
- Date of Birth: ___________________
Agent Information:
- Name: __________________________
- Address: ________________________
- City: ___________________________
- State: __________________________
- Zip Code: _______________________
- Phone Number: ___________________
Child Information:
- Name: __________________________
- Address: ________________________
- City: ___________________________
- State: __________________________
- Zip Code: _______________________
- Date of Birth: ___________________
Authority Granted:
The Agent is granted the authority to make decisions regarding the following:
- Medical care and treatment
- Education and schooling
- Travel arrangements
- General welfare and custody
Effective Date:
This Power of Attorney shall be effective immediately and shall remain in effect until revoked in writing by the Principal.
Signature:
By signing below, the Principal acknowledges that they understand the nature of this Power of Attorney and its implications.
Principal's Signature: ___________________________
Date: ___________________________
Witness Signature: ___________________________
Date: ___________________________
Notary Public:
State of Arkansas, County of ________________
Subscribed and sworn before me this _____ day of ______________, 20____.
Notary Public Signature: ___________________________
My Commission Expires: ___________________________