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Samples:
Caregiver's Authorization Affidavit
De Facto Parent Declaration
Power of Attorney
Letter to Attorney
Letter to Social Worker
Letter to Probation Officer
Letter to Judge
Letter to Family Law Facilitator
Letter to Court Clerk
 
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Power of Attorney

I, ______________________________, being of sound mind and body, declare the following:

  1. That I am the natural mother (father) of ________________________________________________________________.
     
  2. That I am presently incarcerated at ________________________________________________________________.
     
  3. That, during this time, my ___________________________ is being cared for by _________________________________________.
     
  4. That I wish to give full Power of Attorney to ___________________________ with respect to the care and custody of my ____________________________________.
     
  5. That, specifically, I give ___________________________ full Power of Attorney with respect to the care and custody of ______________________________ in matters affecting _____ medical needs, schooling, public assistance and Medi-Cal, legal matters, and all other matters pertaining to the well-being of my child.

I declare under penalty of perjury that the preceding statement is true and correct, and that I signed this statement with full knowledge of its contents, this _____ day of _________, 20___, in ____________________, California.
 
 

_________________________________
          Signature

STATE OF CALIFORNIA           )
                              )     SS.
COUNTY OF ____________________)

Subscribed and sworn to before me a notary public this _____ day of __________, 20____.

______________________________
     Notary Public

My commission expires:

____________________

 

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