Power of Attorney for a Minor Child - Pennsylvania

Pennsylvania · Fillable PDF · Free

Parents use this form to let a grandparent, relative or trusted adult care for their child while the parents are away, such as consenting to medical care, handling school matters, or traveling with the child. It does not change custody. Parents use this form to let a grandparent, relative or trusted adult care for their child while the parents are away, such as consenting to medical care, handling school matters, or traveling with the child.

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Who this form is for

Parents use this form to let a grandparent, relative or trusted adult care for their child while the parents are away, such as consenting to medical care, handling school matters, or traveling with the child. It does not change custody.

What you'll need

The original Power of Attorney for a Minor Child - Pennsylvania packet and its instructions.
The names, dates and supporting records identified in this packet.
Acceptable identification if a notarial act is requested; arrange any required qualified witnesses.

How to complete it

Sign the Notice page (Page 1) Pennsylvania requires this Notice on every power of attorney.
List parents, children and the caregiver (Parts 1–3) Use full legal names and dates of birth.
Check the authority you grant (Part 4) Schools and doctors look for the specific box. Check international travel only if needed.
Set the dates (Part 5) Choose a clear start and end date.
Sign before a notary and two witnesses Both parents should sign if possible. Bring a current government photo ID.
Caregiver signs the Acknowledgment The caregiver signs the agent acknowledgment page.

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Standby Guardian Designation - Pennsylvania

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These forms are a free convenience, not legal advice. First Choice Mobile Notary & Apostille is not a law firm. Consult an attorney licensed in the relevant state for legal questions.

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