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FLORIDA MINOR (CHILD) POWER OF ATTORNEY
1. The Minor. The purpose of this Minor Power of Attorney is for ______________________
[Minor’s Full Name] born on ______________________, 20____ (Hereinafter known as the
‘Minor’).
2. The Parent(s)/Guardian(s). I/We, ______________________ [Name(s) of Parent(s) /
Guardian(s)], the Parent or Court-Appointed Guardian with a street address of
______________________ [Street Address], ______________________ [City],
______________________ [State].
3. Attorney-in-Fact. I/We hereby appoint ______________________ [Name of Attorney-in-
Fact], who is the ______________________ [Relation to Minor] of the Minor, with a street
address of ______________________ [Street Address], ______________________ [City],
______________________ [State] (Hereinafter referred to as the ‘Attorney-in-Fact’) as the
Attorney-in-Fact for the Minor.
4. Powers. I/We delegate to the Attorney-in-Fact the powers of: (Initial the appropriate field(s))
______ - All legal authority that I/we have as the minor’s parent/guardian(s) in the State
of governing law.
______ - ONLY the authority to _____________________________________________
______________________________________________________________________
5. Effective Date. This power of attorney document shall be effective beginning on
______________________, 20____ and shall terminate on: (Initial the appropriate field(s))
______ - On the date of ______________________, 20____.
______ - In the event of my/our disability.
______ - In the event of my/our death(s).
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Regardless of the above-mentioned termination, this Minor Power of Attorney may be
terminated by the Parent/Court-Appointed Guardian executing a revocation or by creating a new
Minor Power of Attorney.
6. Governing Law. This Minor Power of Attorney Form shall be governed under the laws in the
State of Florida and, once effective, terminates any prior Minor Power of Attorney.
Parent / Guardian’s Signature _______________________________
Print Name __________________ Date __________________
Parent / Guardian’s Signature _______________________________
Print Name __________________ Date __________________
Acknowledgment by Attorney-in-Fact
I, the undersigned Attorney-in-Fact, acknowledge and execute this Minor Power of Attorney
Form, and hereby affirm that I accept the appointment and understand the accompanying
responsibilities under the Power of Attorney and under the law.
Attorney-in-Fact’s Signature ________________________
Print Name __________________ Date __________________
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NOTARY ACKNOWLEDGMENT
State of __________________
__________________ County, ss.
On this day, the __ of __________________, 20____, before me appeared
________________________ and ________________________, the Parent(s)/Court-
Appointed Guardian(s) of ________________________ [Name of Minor] who proved to me
through government-issued photo identification to be the above-named person(s), in my
presence executed foregoing instrument and acknowledged that they executed the same as
their free act and deed.
_________________________________________
Notary Public’s Signature
Print Name: _____________________
My Commission Expires: __________________