Maine Power of Attorney for Temporary Care of a Minor Child

MAINE POWER OF ATTORNEY FOR TEMPORARY CARE OF A MINOR CHILD

Before you use this: This separate instrument supplies the delegated authority contemplated by the temporary-custody agreement. If a covered nonprofit helps execute it, § 5-127(4) requires checks of the agent and adult household members. The signer retains parental or legal authority and responsibility.

1. Signer, child, and agent

I, [PARENT OR GUARDIAN FULL NAME], of [ADDRESS], telephone [NUMBER], am the child's ☐ parent ☐ guardian appointed by [COURT, CASE NUMBER, ORDER DATE]. I appoint [AGENT FULL NAME], of [ADDRESS], telephone [NUMBER], as my attorney-in-fact.

Other parent or guardian and contact: [________________]. Relevant orders or restrictions: [________________].

2. Powers delegated

I delegate only the checked powers I hold for the child's temporary care:

☐ Daily care, housing, meals, clothing, supervision, and transportation.

☐ School enrollment, education decisions, school records, and activities.

☐ Medical, dental, and mental-health care decisions and records, to the extent I may lawfully authorize them.

☐ Management of the child's property or benefits solely for the child's interests, limited to [DESCRIBE].

☐ Other specific care or custody powers: [DESCRIBE].

Powers withheld and special directions: [________________________________].

The agent may not consent to the child's marriage, adoption, or termination of parental rights. This instrument does not override a court order.

3. Term and military extension

This power begins on [__/__/____] and ordinarily expires on [__/__/____], no more than 12 months later. I may revoke or amend it in writing delivered to the agent and other interested persons.

☐ No military extension is claimed.

☐ Qualifying National Guard or Reserve extension applies under § 5-127(2). I am under an active-duty order lasting more than 30 days in support of ☐ an involuntary reserve-component operational mission ☐ forces activated during a congressionally declared war or a national emergency declared by the President or Congress. Order and attachment: [________________]. Unless this power states otherwise or a court orders otherwise, the statutory extension lasts until 30 days after that order ends.

Funds, care arrangements, and contact with me: [________________________________].

When this power expires or ends, the child must be returned to my custody as soon as reasonably possible unless a court orders otherwise.

4. Signatures and filing

I grant this power for temporary care and do not intend to divest my parental or legal responsibility.

Parent or guardian signature: ______________________________ Date: [__/__/____]

Agent acceptance: I accept the appointment and will honor its powers and term.

Agent signature: ______________________________ Date: [__/__/____]

☐ I am a court-appointed guardian. This power becomes effective only when filed with the appointing court. Court: [________________]. Case number: [________________]. Date filed: [__/__/____].

☐ I am a parent or guardian whose appointment was not by court.

Notary acknowledgment

State of [STATE], County of [COUNTY]. Acknowledged before me on [__/__/____] by [PARENT OR GUARDIAN NAME].

Notary signature: ______________________________ Commission expires: [__/__/____]

Official source

• 18-C M.R.S. § 5-127