Fill and Sign the Hotline Tip What Does Ss Mean on a Notarial Certificate Form

DELEGATION OF POWERS BY PARENT MINN. STAT. § 524.5-211STATE OF MINNESOTA)) ss.COUNTY OF )KNOW ALL PERSONS BY THESE PRESENTS THAT:1.I, , of the County of , State of Minnesota, am the parentof , born , .2.I hereby appoint , of the County of , State ofMinnesota, to be my true and lawful Attorney in Fact for the exercise of parental authority over mychild, , for a period of _____________ (upto one year) following the date of my signature, pursuant to MINN. STAT. § 524.5-211. 3.This Power of Attorney hereby constitutes my delegation to ,of my parental powers and authority regarding the care, custody, and property of , including, but not limited to the authority to:a.authorize medical treatment;b.enroll my child in school; andc.provide a home, care, and supervision of my child at the home of .This Power of Attorney does not authorize to consent tomarriage or adoption of .I, ____________________________, understand that I am legally obligated, pursuant to MINN.STAT.§ 524.5-211(b) to mail or give a copy of this document to any other parent within 30 days ofits execution unless:a.the other parent does not have visitation rights or has supervised visitation rights; or b.there is an existing order for protection under chapter 518B or similar law of another state ineffect against the other parent to protect me. IN TESTIMONY WHEREOF, I have hereunto set my hand this day of ,200 . Signature of Parent or Guardian Subscribed and sworn to before methis day of , 200 ____________________________Notary PublicI hereby accept the foregoing Delegation of Parental Authority over . Signature of Attorney in Fact