Nebraska Minor Child Power of Attorney Form

The Nebraska minor child power of attorney form is a document that may be utilized by parents of minors to assign an Agent powers so that they may temporarily care for their child(ren) in the event of emergency, absence or illness.

This document will provide permission to care for the child(ren) as if the parent(s) were available and able to care for the child(ren) on their own. No Agent will have any right to provide signature for any child(ren) for marriage or to be adopted under any circumstances

This document must be created by the parent before a notary public. The document may be revoked by the parent(s) at any time, by providing notice in writing and delivering it to the Agent.

How to Write

Step 1 – Parental Information – Enter:

  • Enter the full name of the Principal
  • City of Residence
  • AND
  • The full name of the appointed Agent
  • Agent’s Address
  • City
  • State
  • AND
  • Enter the name(s) of the Child(ren) (if there are more children who must be listed, enter the children’s name on a separate sheet and attach to this form
  • Enter the child(ren’s) dates of birth in mm/dd/yyyy format

Step 2 – Agent –

  • Enter the name of the appointed Agent in the next three fields provided as the Principal reads through the remainder of the document

Step 3 – Notarization –

  • Once the document has been completed before a notary, the notary shall complete the remaining portion of the document in acknowledgement.