New York Minor Child Power of Attorney Form

The New York minor child power of attorney form is a document that allows parents to authorize and Agent(s)/Guardian(s) powers that will allow the Guardian(s) all of the powers needed to properly care for their child(ren) in their absence. The document will allow parent(s) to allow full authority or limited authority over their children. The parent(s) may specify.

This document will require the signatures of two (2) witnesses as well as licensed Notary Public. As well, this document may be revoked by the parent(s) in writing and by delivery to the Agent(s) at any time.

How to Write

Step 1 – Child(ren’s) Information – (If there is more than one child, continue on an added sheet, providing the same following information):

  • Enter the name(s) of the child(ren)
  • Provide the child(ren’s) date(s) of birth in dd/mm/yyyy format
  • Submit the name of the parent or court appointed guarding and indicate who the person is to the child(ren) by checking the applicable box
  • Address
  • City
  • State
  • Enter also the same information regarding a co-parent or guardian

Step 2 – Appointment of Agent/Guardian – Enter the following:

  • The name of the Agent/Guardian

Their relationship to the children

  • Address
  • City
  • State

Step 3 – Delegation of Powers to the Agent/Guardian(s) –

The parent(s) must select and initial the box that best indicates their wishes, as follows:

  • All authority that I have as the minor’s parent/guardian
  • OR
  • Only the authority to (enter the limited powers allowed)
  • Enter the date of the commencement of the document in dd/mm/yyyy format
  • Select the conditions of the termination of the document. The Principal may provide an initial termination date in mm/dd/yyyy
  • If the parent(s) choose, they may also select the other options in the event of occurence

Step 4 – Signatures – All to be signed before a notary, as follows:

  • Enter the parent(s) or court appointed guardian signature(s)
  • Print name(s)
  • Date in mm/dd/yyyy format

Step 5 – Acceptance by Agent/Guardian –

The Agent/Guardian must read and agree to the paragraph in this section before provision of signature(s). If the Agent/Guardian is in agreement

  • Provide the Agent/Guardian(s) signature(s)
  • Printed name
  • Date of Signature in mm/dd/yyyy format

Step 6 – Affirmations by Witnesses – The Witnesses must read the affirmation statements. If in agreement, enter:

  • The names of the Witnesses in their respective sections
  • Witnesses signatures
  • Printed Names
  • Date each signature in mm/dd/yyyy format

Step 7 – Notary Acknowledgement –

As the Notary Public has witnessed all signatures, they shall complete the remainder of this document by providing required information acknowledging the information and signatures on the document.