Fill and Sign the Dc 6 10 1adoc Form

INSTRUCTIONS FOR COMPLETING THE TEMPORARY DELEGATION OF PARENTAL POWERS First Paragraph • In the first blank enter your full name. • In the second blank enter the city where you live. • In the third blank enter the full name of the person to whom you are appointing parental powers. • In the fourth blank enter the address, city and state where the person you are appointing resides. • In the fifth blank enter the full name of the child for whom you are delegating your parental powers. • In the sixth blank enter the child’s date of birth (month, day, and year). • In the seventh, eighth and ninth blanks enter the full name of the person to whom you are appointing parental powers. Final Paragraph: Enter the month, day, and year you are signing the Temporary Delegation. SIGNATURE BLOCK: ONLY WHEN YOU ARE BEFORE A NOTARY PUBLIC, on the first line sign your full name Enter the date that you are signing this complaint. Enter your first, middle and last names. Enter your street address/P.O. Box. Enter your City, State and Zip Code. Enter your e- mail address. Enter your phone number. VERIFICATION In the presence of a notary public, sign your name. DO NOT SIGN THE TEMPORARY DELEGATION UNTIL YOU ARE BEFORE A NOTARY PUBLIC. Instructions for Completing the Temporary Delegation of Parental Powers, DC 6:10.1a Rev. 06/19