8/19/2019 carta poder version en ingles

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A Sample Power of Attorney Form

I/we are the parent(s) of______________________________,

born_______________, a minor child. I/we give

to:________________________the full authority to act in my/ourplace regarding any matter concerning the care, custody, or property

of this child, including, but not limited to: granting of consent for

any medical, dental, psychological, psychiatric examinations, care,

or treatment including vaccinations or immunizations; enrollment in

school and participation in school activities; applying for public

benefits; and any other matter regarding the health or welfare of this

child

except:______________________________________________________.

This power of attorney shall be valid for a period ending but in no

case for more three years.

I/we reserve the right to terminate (end) this authority at any time.

Signed:_________________________________________________

_

SIGNED AND SWORN TO before me on this______ day of

________,

20___,by_______________________________________________

_.

Signature of

Notary:_______________________________________