Louisiana Minor Child Power of Attorney Form

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Updated on June 13th, 2023

The Louisiana Minor Child Power of Attorney, or as it is referred to within the content of the state’s law, a “Provisional Custody by Mandate”, is the statutory form used to grant certain parental rights to an agent (mandatary). This is specifically designed for parents/guardians who will be away from their child for a short period of time and want to ensure that the temporary caretaker has the legal capability to sign off on anything that the minor may require. This could relate to the minor’s healthcare treatment, dental procedures, education, etc. The application of this instrument will require that the parents/guardians provide it with the requested information as well as their endorsement (signatures should be acknowledged by two (2) witnessing parties and a notary public).

Other Versions (4)

Department of Public Safety & Corrections Version

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eForms Version

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Louisiana State Bar Association Version

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Luneau Law Office Version

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Additional Resources

Related Forms

Revocation of Power of Attorney

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