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Oregon Parental Guardianship Power of Attorney Form

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Oregon Parental Guardianship Power of Attorney Form Page 3
Oregon Parental Guardianship Power of Attorney Form
This delegation does not include the power or authority of the attorney-in-fact to consent to the
minor child/ren’s marriage or adoption.
SELECT ONE:
This power of attorney is effective for a period not to exceed six months, beginning
_______________, 20__, and ending ______________, 20__. I reserve the right to revoke this
authority at any time.
I am in the US Armed Forces and have been called to active duty This power of
attorney is effective through my active duty period plus 30 days.
By:__________________________________
(PARENT/LEGAL GUARDIAN SIGNATURE)
I hereby accept my designation as attorney-in-fact for ____________________________
(MINOR CHILD/REN)
as specified in this power of attorney.
_______________________________
(
ATTORNEY-IN-FACT SIGNATURE)
Page 2 of 2, DELEGATION OF PARENTAL/GUARDIAN POWERS
POA Form Instructions 1P-15Ver01.wpd (12-04)
Oregon Parental Guardianship Power of Attorney Form