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New York Minor Child Power Of Attorney

New York

New York Minor Child Power Of Attorney — a 8-page New York PDF form with 42 fill-in fields and a notary block.

  • 8 pages
  • 42 fill-in fields
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Not yet rated1 downloadsUpdated Aug 21, 2026
First-page preview of New York Minor Child Power Of Attorney
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Information you will need

  • Parent / Guardian Street Address
  • Designated Person Phone
  • Duration
  • Initials
  • Start Date
  • End Date
  • Child/Incapacitated Person Name
  • Child/Incapacitated Person DOB
  • School Records
  • School Enrollment
  • Excuse School Absence
  • School Programs/Activites
  • School Related Medical Care
  • Health Plans
  • General Health Care
  • Medical Procedures
  • Dental Care
  • Developmental Screening
  • Mental Health
  • Immunizations
  • Authority Limitation
  • Second Parent/Guardian Name
  • Second Parent/Guardian Address
  • Parent/Guardian Home Phone

…and 18 more fields in the PDF.

Completed by the provider.

The form includes a notary acknowledgment, a witness section.

PDF facts

Format
PDF
File size
743 KB
Pages
8
Version
1