In an ever-evolving world, unforeseen circumstances arise where parents must grant someone else temporary authority over their children.

The ‘District of Columbia, Custodial Power of Attorney’ is designed to facilitate this process, ensuring that children’s care and custody are legally handed over to a trusted individual in the parent’s absence.

Here’s your guide:


Step 1: Parent’s Name



This is the beginning of a formal declaration, signifying your intent to provide temporary guardianship over your children.

Your full name makes the document specific to you and your child(ren).

I, Elizabeth Turner, am the parent of the child(ren) listed below…


Step 2: My Address



Here, you’ll provide your complete residential address. It offers a point of contact and reinforces the document’s authenticity by anchoring it to a real-world location.

123 Elm Street
Washington, D.C., 20001


Step 3: Third Party’s Name and Address



This trusted adult will temporarily hold custodial rights over your child(ren). Their full name and address are crucial to ensure no ambiguity about who you’re entrusting with your child’s well-being.

John Doe is an adult whose address is:
456 Maple Drive

Washington, D.C., 20002



Step 4: Children’s Details




This section outlines the specifics: which children are being entrusted? By listing each child’s name and date of birth, you’re ensuring clarity and specificity.


Name: James Turner Date of Birth: 1st Jan 2010
Name: Anna Turner Date of Birth: 5th Feb 2013


Step 5: Parental Rights and Responsibilities




Here, you will detail the rights and responsibilities you entrust to the third party. This can range from making educational decisions, medical care, or even day-to-day activities like extracurricular participation.

I grant John Doe these parental rights and responsibilities regarding James and Anna: making educational decisions, authorizing medical care, and overseeing daily activities and extracurriculars.





Step 6: Initial The Line In Front Of Each Power You Are Granting




The form asks for specific rights or powers you wish to grant. Your initials serve as a personalized stamp of approval, ensuring that each specific power is clearly given with your full understanding and consent.

If Jane Doe wishes to grant physical custody, she would initial next to the relevant line.
JD physical custody of the child(ren) listed above;





Step 7: Physical custody of the child(ren) listed above



This is about where the child will live and who they’ll stay with. Granting physical custody means the child will live with the attorney-in-fact.

Having physical custody means the attorney-in-fact can provide a stable environment, ensuring the child’s day-to-day needs are met.




Step 8: The authority to enroll the child(ren) listed above in school



This allows the attorney-in-fact to decide which school the child attends, from kindergarten to high school.

If the child moves residences, the attorney-in-fact can ensure they attend a school in the new locality. This ensures continuous learning without the need for parental intervention every time.



Step 9: The authority to obtain educational records regarding the child(ren) listed above



This provides access to all academic records, like report cards and attendance records.

This is vital for understanding the child’s academic progress and any areas needing attention.




Step 10: The authority to make all school-related decisions for the child(ren) listed above



This is broader and covers decisions about extracurricular activities, parent-teacher meetings, and any other school-related matters.

Ensures the child has a seamless academic experience, with someone always there to make necessary decisions.





Step 11: The authority to obtain medical, mental health, or dental records regarding the child(ren) listed above



This allows the attorney-in-fact to access the child’s health records.

This is essential for understanding the child’s health history, especially if a medical emergency arises.




Step 12: The authority to consent to medical, mental health, or dental treatment for the child(ren) listed above



This means the attorney-in-fact can approve any treatments or procedures the child might need.

This enables the child to receive prompt medical attention in the parent’s absence.




Step 13: The authority to act as representative payee for any Social Security benefits for which the child(ren) listed above may be eligible



Here, the attorney-in-fact can receive and manage Social Security benefits for the child.

This is helpful if the child is entitled to such benefits. This ensures they’re used appropriately for the child’s needs.




Step 14: This custodial power of attorney does not include authority



This section clearly states the boundaries of the power you’re granting. It means that these fundamental rights remain unchanged regardless of the permissions above.

This ensures there are limits on the attorney-in-fact’s authority, providing a safeguard against potential misuse.

Regardless of permissions granted, the third party cannot decide on the child’s religious affiliation.




Step 18: The custodial power of attorney granted in this form is further limited by these instructions



Your chance to add personalized stipulations, further defining the attorney-in-fact’s role. These include specific situations, time frames, or conditions you want adhered to.

The attorney-in-fact shall consult with me before making any major educational decisions for the child.




Step 19: The custodial power of attorney granted in this form shall continue until I revoke it 




Here, we’re discussing the duration and revocability of the powers granted in this document. This blank space is where you’d input the name of the third party, often the attorney-in-fact. They must be formally informed of the revocation to ensure they know they no longer hold the powers previously granted.

John Smith, the parent, has decided to revoke the powers granted to Jane Doe. After writing a formal revocation letter, he must send it to Jane, informing her that she no longer holds the powers associated with the child’s care.




Step 20: Signature Date


Your signature, the final touch, ratifying everything above. It’s your consent, ensuring that this document is legally binding and represents your clear intentions.

Signed this 5th day of August 2023.




Step 21: Parent’s Signature



This is your endorsement, confirming everything stated in the document and signifying your consent. By signing here, you verify that the decisions and permissions outlined in the document are made willingly and not under any form of pressure.

Jane Doe (This would be the parent’s name providing this authority).




Step 22: Acknowledgement Date



This section is for the notarial officer to confirm that you, the parent, signed this document in their presence. Doing so provides additional validation to the document, ensuring it’s free from forgery.

This document was acknowledged before me on 5th day of August, 2023 by Jane Doe.




Step 23: Signature of notarial officer



This is where the notary public (or similar official) will sign, giving the document further legal credibility. Their signature verifies that they personally witnessed the parent signing the document.

John Smith, Notary Public




Step 24: Expiration Date



This indicates when the notary public’s commission (or license to act as a notary) ends. It’s important because it establishes the timeframe within which the notary’s endorsement is valid.


My commission expires 15th of March 2025.








In conclusion, the District of Columbia Custodial Power of Attorney isn’t just another piece of paperwork; it’s a safeguard, a layer of protection ensuring your child(ren)’s well-being in unpredictable circumstances.

Remember, it’s not about relinquishing control but ensuring continuity in your child’s life.

As you fill this out, remember the trust and responsibility you bestow, and choose your third party wisely. This document reinforces the idea that raising a child truly takes a village.