PLANNING FOR THE CARE OF YOUR CHILDREN
IF YOU ARE DETAINED OR DEPORTED
            Many undocumented immigrants with children worry about who will care for their
            children if one or both parents is suddenly arrested or deported. This packet will
            guide parents in creating a plan for the care of children after a parent is detained.
            The packet contains general information but cannot address every family’s situation.
            If you believe that your situation is not addressed by this guide, or if you have any
            questions, please consult an attorney for advice.
    Tips:
    •	 Start working on your plan right away so it will be ready in case of an emergency.
    •	 As you plan, be sure to talk with the people who will help you carry out your plan so they understand and
       agree.
    •	 Try to memorize important phone numbers that you may need in an emergency.
    •	 In addition to planning for the care of your children, you may also need to make plans for your finances
       and property. You may consider giving someone your “Power of Attorney” to deal with these issues. More
       information about a power of attorney can be found at saveimmigrantfamiliesusa.com. You can also check
       Santa Maria or Su Casa for more resources.
    •	 For information about your rights when dealing with immigration officials and police, see page 12.
    •	 The information about the law contained in this packet is specific to Ohio.
    •	 Beware that “Notarios” cannot practice law. It you need legal advice, consult an attorney.
    The materials available in this packet are provided for general information purposes only and do not constitute
    legal advice. This packet is not intended to create an attorney-client relationship between you and the Legal Aid
    Society of Greater Cincinnati.
1
                                                                                                                   7/17 FA-13
     If I Am Deported I Plan To…
                                                                  1.	 Collect important documents listed on page
                                                                      3 and fill out important information sheet on
                                                                      page 4.
              TAKE MY CHILDREN WITH ME
                                                                  2.	 Obtain or update the children’s passports (page
                                                                      5).
                                                                  1.	 Collect important documents listed on page
                                                                      3 and fill out important information sheet on
                                                                      page 4.
                                                                  2.	 Obtain or update the children’s passport (page
                                                                      5).
                                                                  3.	 Decide how the children will travel and set aside
                                                                      the money for their tickets.
                                                                  4.	 Find out what documents the airline or bus
                                                                      company will need if someone who is not the
                 HAVE SOMEONE BRING
                                                                      parent will be transporting them.
                  MY CHILDREN TO ME
                                                                  5.	 Find out what documents the border authority
                                                                      in your country will need if a non-parent tries to
                                                                      bring the children to join you.
                                                                  6.	 Obtain two sets of certified copies of the chil-
                                                                      dren’s U.S. birth certificates, custody and child
                                                                      support orders, and medical and school records
                                                                      (if applicable). Take one set with you and give
                                                                      one set to the person who will be caring for your
                                                                      child while you are separated.
                                                                  1.	 Collect important documents listed on page
                                                                      3 and fill out important information sheet on
                                                                      page 4.
                                                                  2.	 If the children will be left with their other par-
                                                                      ent, it may or may not be necessary to obtain
                                                                      court orders (page 6).
                LEAVE MY CHILDREN HERE                            3.	 If the children will be left with their grandpar-
                  WITH SOMEONE ELSE                                   ent, you could sign a Grandparent Power of At-
                                                                      torney or the grandparent can sign a Caretaker
                                                                      Authorization Affidavit (page 9).
                                                                  4.	 If someone else other than a grandparent will
                                                                      be providing care, he or she will need to obtain
                                                                      custody or guardianship to have full powers to
                                                                      care for the child (page 6).
    You may also want to sign a Child Care Power of Attorney (see page 11). This document is not a substitute for
    someone having custody or guardianship of the children. However, it may help the person who is bringing your
2   children to you, or the new caregiver who is waiting for a custody order from the court.
    Important Documents
    Keep these documents in a safe place. Tell your children, family members and emergency caregiver where to find
    them in an emergency. You may want to make an extra copy for a trusted person to hold.
    You may also want to check with your consulate about what you may need to do in order for certain documents
    to be accepted in your home country.
    Generally Important Documents:
     Passports (you, your spouse and each of your children)
     Birth Certificates (you, your spouse and each of your children)
     Marriage License or Divorce Decree (if applicable)
     Any Protection or Restraining Orders you may have against anyone (if applicable)
     Any ongoing Court Orders regarding child custody or parental rights (if applicable)
     Any ongoing Court Orders regarding immigration status (of you or your spouse) (if applicable)
     A-Number and any immigration documents (work permit, green card, visa, etc.) (if applicable)
     Driver’s License and/or other Identification Cards
     Social Security Card or ITIN number (for you, your spouse and each of your children) (if applicable)
     Registry of Birth (for U.S. born children registered in parent’s home country) (if applicable)
     Important Children’s Information (see page 3 of this packet)
     Emergency Numbers and Important Contact Information (see page 4 of this packet)
     Any other documents you would want to be able to find quickly
3
                                                            EMERGENCY NUMBERS AND IMPORTANT CON-
    Important Information                                   TACT INFORMATION
                                                            Keep this information in one place so that you and your
                                                            family can access it easily
    CHILD’S IMPORTANT INFORMATION
    Keep this information for you or any caregiver you      Family Contacts
    designate to provide for your child(ren)                Mother/Parent/Guardian:
                                                            Name:_______________________________________
    General Information about Child(ren):
                                                            Social Security #:_______________________________
    Child’s Full Legal Name:_________________________
                                                            Passport #:____________________________________
    Child’s Social Security #:_________________________
                                                            Home Address:________________________________
    Passport # (if applicable):________________________
                                                            Home Phone Number:__________________________
    Child’s Date of Birth:____________________________
                                                            Cell Phone Number:____________________________
    Child’s Place of Birth:___________________________
                                                            Work Address:_________________________________
    Child’s Cell Phone Number (if applicable):___________
                                                            Work Phone Number:___________________________
    Child(ren)’s School & Activities:                       Father/Parent/Guardian:
    School Name and Address:_______________________         Name:_______________________________________
    School Phone Number:_________________________           Social Security #:_______________________________
    Teacher and/or Principal’s Name:__________________      Passport #:____________________________________
    Afterschool Program Name (if applicable):__________     Home Address:________________________________
    Afterschool Program Phone Number:______________         Home Phone Number:__________________________
    Schedule_____________________________________           Cell Phone Number:____________________________
    Other Camp/Sports/Program:____________________          Work Address:_________________________________
    Other Camp/Sports/Program Phone Number:_______          Work Phone Number:___________________________
                                                            Family/Important Contact in Home Country:
    Medical Information:
                                                            Name:_______________________________________
    Allergies:_____________________________________
                                                            Home Address:________________________________
    Medical Conditions:____________________________
                                                            Home Phone Number:__________________________
    Medications:__________________________________
                                                            Cell Phone Number:____________________________
    Doctor’s Name and Phone Number:_______________
                                                            Work Phone Number:___________________________
    Doctor’s Address:______________________________
                                                            Relationship:__________________________________
    Pharmacy’s Name and Phone Number:_____________
    Pharmacy’s Address:____________________________         Child’s Health Insurance Information
    Dentist’s Name and Phone Number:_______________         Company:____________________________________
    Preferred Hospital:_____________________________        Phone:_______________________________________
                                                            Policy #:______________________________________
                                                            Legal Information
                                                            Attorney
                                                            Name:_______________________________________
                                                            Phone:_______________________________________
                                                            Case Numbers and Court Names for any Cases:
                                                            Child Custody/Guardianship/Divorce:______________
                                                            Civil Protection Orders/Restraining Orders:_________
4
                                                            Immigration Proceedings:________________________
    Passports for U.S. Citizen Children
    Some parents plan to take their U.S. citizen child back to their home country if they are deported. If that is your
    plan, find out if your child will need a U.S. passport or passport from your home country to enter your home
    country.
    If your child later wants to re-enter the U.S., he or she will need a U.S. passport. This page provides information
    about how to apply for a U.S. passport in the U.S. You may also be able to obtain a U.S. passport for your child at
    the U.S. Embassy or Consulate in your home country.
    The application is available at: https://travel.state.gov/content/passports/en/passports/under-16.html. The
    passport will usually arrive approximately 6-8 weeks after you apply. You can pay more for “expedited service” if
    you want the passport to arrive in approximately 2-3 weeks.
    The process for obtaining a U.S. passport is different depending on your family’s situation. Check with Su Casa
    or Santa Maria to see if free help is available to apply for a passport.
    To obtain a U.S. passport for your child in the U.S. who is under 16 years old, the child must appear in person at
    the post office. Find your situation below to determine what else is necessary.
                            Both parents agree to                                  One parent wants a passport
                           obtain a passport for the                              for the child and is available to
                                     child.                                               apply in person.
     Both parents are         Only one parent is       Neither parent is      That parent has        No custody order
     available to apply       available to apply       available to apply      court ordered        exists for the child.
        in person.               in person.               in person.             custody.
       Go to the Post         Unavailable parent       Both parents must       Must include a          File for custody
       Office together          must complete            sign a notarized      certified copy        in court to obtain
        with child to           form DS-3053           statement allowing      of court order           a court order.
     request a passport.         “Statement of             a third party      with in- person       (See page 6-8) for
                                Consent” and              to request the     application at post      information and
                              provide a copy of            passport and            office.             warnings about
                                both front and          provide copies of                           filing for custody.)
                              back of his/her ID.         both front and
                                                        back of their IDs.
                                                                                                            OR
                                                                                                       File Form DS-
                                                                                                      5525 “Statement
                                                                                                     of Exigent/Special
                                                                                                      Circumstances”
5
    One Parent Remains in the U.S. to Care for Children
    If one parent is detained or deported, and the other parent will be remaining in the U.S. to care for the children,
    consult the chart below to determine whether the remaining parent needs to get a court order for custody.
    If you are… Married to the other parent                     Not married to the other parent
    Mother      Under Ohio law, when the parents are            Under Ohio law, if the mother is not married when
                married to each other, both parents have        she has the baby, she has legal custody of the child.
                custody, so there is no need to go to court.    She does not need to go to court for custody.
    Father        Under Ohio law, married parents both          Under Ohio law, a father who is not married to the
                  have custody, so there is no need to go to    mother DOES NOT have custody. Father must go
                  court.                                        to court to ask for custody. See the next section for
                                                                more information.
                                                                  •	 Note: if any court has issued a custody or
    Custody and Guardianship of Children                             guardianship order in the past, usually the new
    Why is custody or guardianship better than a                     request must be filed in that same court. For
    Child Care Power of Attorney?                                    example, if the child’s parents are divorced, the
                                                                     request for custody usually has to be filed in the
    •	 You can give a non-parent caregiver your Power                court where the divorce was granted.
       of Attorney, but some schools, doctors, hospitals,
       and other agencies will not honor it. Only a               •	 Unmarried fathers should file for custody in
       court order for custody or guardianship will give             Juvenile Court. Probate Courts generally do not
       the non-parent caregiver full authority to make               handle guardianship cases involving two parents.
       decisions and obtain services for your child.
                                                                  2. What is required when the parent wants to get
    •	 Also, if someone reports to “Children’s Services”          custody back or terminate the guardianship?
       or “241-KIDS” that your child is not receiving             CUSTODY: After the court gives custody to the
       proper care in your absence, Children’s Services           non-parent caregiver (or to the child’s father, if the
       may be especially concerned if no one has custody          parents are unmarried), it may be very hard for the
       or guardianship of the child.                              parent to get custody back in the future. If the other
                                                                  person does not agree that the parent should have
    How are custody and guardianship different?
                                                                  custody again, it will not be enough for the parent
                                                                  just to say that they want custody back. The parent
    1. Where the case is filed:
                                                                  will have to prove to the court that the non-parent
    •	 A request for custody is filed in Juvenile Court           caregiver is no longer taking good care of the child.
       (see Appendix A for Juvenile Court information).
                                                                  GUARDIANSHIP: Under the law, it may be a little
    •	 A request for guardianship is filed in Probate             easier to terminate the guardianship than it would
       Court (see Appendix A for Probate Court                    be to reverse a custody order from the Juvenile
       information).                                              Court. Even if the Guardian/caregiver does not
                                                                  agree with giving the child back to the parent, the
                                                                  parent should only have to prove that the parent is
                                                                  now fully able to care for the child.
6
    3. Required forms:                                        How to deal with the requirement that both
    Every court has its own forms to file for custody or      parents receive notice about the court case
    guardianship. The forms are available on each court’s     When a custody or guardianship case is filed in
    website. You should review the forms for custody          court, you have to provide the court with an address
    and guardianship to decide if you understand one          where the parents of the children can receive notice
    court’s forms better than the other.                      (called “service of process”) about the case.
    4. Court fees:
                                                              •	 If it will be difficult for the parents to receive
    Each court has its own fees to file for custody or
                                                                 certified mail from the court, it may be helpful for
    guardianship. Information about court fees is
                                                                 the parents to sign a form called “waiver of service
    available on the courts’ websites.
                                                                 of process.” This tells the court that the parent
    The court must send a notice about the court case            gives up the right to receive notice about the case
    to the parents. If the location of one or both of the        by mail.
    parents is unknown, then notice about the court
                                                              •	 The parents can also sign a “consent for custody”
    case may be published in a newspaper, which can
                                                                 or “consent for guardianship.” The consent form
    be very expensive. In Juvenile Court custody cases,
                                                                 tells the court that the parent is in agreement with
    there is a special rule to avoid the fee for caregivers
    with very low income. However, the same rule may             the caregiver’s request for custody or guardianship.
    not apply in Probate Court.                                  The court does not have to honor this, but may
                                                                 take it into consideration.
    When should the custody or guardianship papers            •	 The waiver and consent forms are usually not
    be prepared?                                                 provided by the court.
    Some parents may want to help the caregiver fill out
                                                              How long will the court case take?
    the forms for custody or guardianship now, before
                                                              The first court appearance is usually about eight
    they are detained or deported. This would ensure
                                                              weeks after the papers are filed. At the first hearing,
    that the caregiver has all of the information that he
                                                              the court will check to make sure that both parents
    or she needs when it comes time to file the papers in
                                                              have received notice about the case. The court may
    court.
                                                              also review the information from the background
    If the papers are prepared in advance, the caregiver      check on the caregiver. Typically, the court does not
    should not sign the forms until they are ready to         make an order for custody or guardianship at the
    file them in court. Most of the forms have to be          first hearing. Instead, it will usually schedule at least
    witnessed by a notary public and dated. If the            one or two more hearings to get additional informa-
    signature date is too old by the time the papers are      tion before it makes a final order. Caregivers should
    filed in court, the court may reject them.                expect the process to take up to six months.
    Is there any way to avoid paying the court fee?
    If the caregiver cannot afford the fee to file for
    custody, he or she can ask the clerk for a special
    form to request waiver of the fee (it may be called a
    poverty affidavit, or affidavit of indigency, or motion
    for waiver of filing fee). However, the court may not
    grant the request to waive the fee. Some courts feel
    that if a caregiver cannot afford the fee, then they
    cannot afford to care for the child. Therefore, it is
    best if the caregiver pays the fee to avoid any delay
    in the case.
7
    Some cautions about bringing a custody or
    guardianship case to court
    •	 If any court made orders for care of the children
       in the past, you should seek the advice of a lawyer
       before filing a new case. There are special laws
       that have to be followed when someone is seeking
       to change a past court order.
    •	 As discussed above, parents should be careful
       about asking someone else to obtain custody
       or guardianship of their children, since it may
       not be easy to get the children back if there is a
       disagreement with the caregiver in the future.
    •	 When the caregiver files for custody or
       guardianship, the court has to give notice to
       both parents. Both parents will have the chance
       to come to court and say if they agree with the
       caregiver’s request.
      •	 This may be a problem in some families where
         one parent does not want the other parent to
         know where the child is living.
      •	 It also creates an opportunity for a parent who
         has not been in contact with the child to come
         to court and ask for custody or visitation.
      •	    Under Ohio law, a court is supposed to give
           preference to a parent over a non-parent if
           they are both asking for custody. For example,
           even if the mother wants her sister to have
           custody of the child, the child’s father would
           probably win if he also asks for custody.
    •	 The Juvenile and Probate courts are usually
       not concerned with the immigration status of
       someone who is filing for custody or guardianship.
       However, laws and policies can change at any time.
       A caregiver who does not have legal status in the
       U.S. may not be the best choice. If the caregiver is
       detained or deported, you may not have control
       over what will happen to your child.
    •	 Courts usually require that anyone who files for
       custody or guardianship of a child must have
       a background check. The background check
       will include any record of criminal charges and
       any history with Children’s Services. The court
       may appoint someone to visit and inspect the
       caregiver’s home. If there are other adults living
       in the home, the court may require that they also
       have background checks.
8
    Options for Grandparents Caring for their Grandchildren
    Grandparents caring for their grandchildren can file the “Grandparent Power of Attorney” or the “Caretaker
    Authorization Affidavit” depending on their circumstances. The forms are created under Ohio law. Schools and
    medical providers must accept these forms.
    GRANDPARENT POWER OF ATTORNEY                                 CARETAKER AUTHORIZATION AFFIDAVIT
    When to use this option:                                      When to use this option:
    Grandparent has or will have physical custody of a            Grandparent has physical custody of a child whose
    child, the parent or parents agree with this, and             parents cannot be located. The grandparent must
    parent or parents are available to sign the Power of          attempt to locate the parents before signing this
    Attorney (POA for short).                                     paper.
    What it allows the grandparent to do:                         What it allows the grandparent to do:
    •	 Arrange for the medical, dental and psychological          •	 Arrange for the medical, dental and psychological
       treatment                                                     treatment
    •	 Enroll the child in school                                 •	 Enroll the child in school
    •	 Access the child’s school records                          •	 Access the child’s school records
    •	 Provide consent for educational activities                 •	 Provide consent for educational activities
    •	 Make all decision for the daily care of the child as       •	 Make all decision for the daily care of the child as
       a parent would                                                a parent would
    Ends when:                                                    Ends when:
    •	 The parent or custodian files a form in court              •	 Child moves from Grandparent’s household
       stating that the POA is revoked
                                                                  •	 Parent or guardian changes one of the decisions
    •	 The Grandparent files a paper in court to                     made by the grandparent
       terminate the POA
                                                                  •	 Court orders termination of the Caretaker
    •	 Court orders termination of the POA                           Authorization Affidavit
    •	 Either the child or Grandparent dies                       •	 Either the child or Grandparent dies
    How to use these options:
    1.	 Obtain the appropriate forms from the Juvenile Court in the County where the child will be living with the
      grandparent. However, if there is a prior custody order from another County, the forms will have to be filed in
      that County.
      Note: Caretaker Authorization Affidavits in Butler County can only be obtained in person at the Clerk’s office.
      All other forms are available on the websites of the Butler and Hamilton County Juvenile courts, or you can go
      to the court to pick them up.
    2.	 Sign all forms in front of a notary public.
    3.	 You must file the forms with the Juvenile Court within 5 days after they are signed.
    4.	 If both parents have not signed the Grandparent POA, you must provide an address where the court can notify
      the other parent that a Grandparent POA has been signed. The court may make an exception if you show that
      you have tried and cannot locate the other parent’s address.
    Fees: There is no fee to file these forms with the court.
9
     CHILD CARE POWER OF ATTORNEY                              When to use this option:
     A parent can give their Power of Attorney to a            In order to have full authority to care for your
     caregiver to act on the parent’s behalf to care for       children and make decisions for them, a non-parent
     their child if they are unavailable to do so. (Note: if   caregiver needs to go to court to obtain custody or
     you are a grandparent, see page 10 for the forms that     guardianship. However, a custody or guardianship
     apply just to grandparents.). However, a Child Care       case in court can take many months until there is
     Power Of Attorney does not cover every situation          a final order. While the caregiver is waiting for a
     that a family may face. Read below for more               final order, a Child Care Power Of Attorney may
     information.                                              give them the authority they need for the child’s
                                                               immediate needs.
     What it allows you to do:
     This document gives a caregiver limited power to          How to do it:
     make decisions for a child’s IMMEDIATE NEEDS.             1.	 Complete a Power of Attorney form
     IT IS NOT A SUBSTITUTE FOR CUSTODY OR
                                                                 (see attachment on page 14).
     GUARDIANSHIP OF THE CHILD. In fact, there
     is nothing in Ohio law that would require a doctor,       2.	 The document must be signed and witnessed by
     school or anyone else to accept this type of Power of       a Notary Public, but does not need to be filed in
     Attorney.                                                   Juvenile Court.
     As you are making your plan, you should contact           Ends when:
     your children’s school and medical providers to ask       The parent can revoke (terminate) the power of
     if they would accept a caregiver Child Care Power of      attorney at any time. The parent does not need to
     Attorney form so that the caregiver can:                  file anything in court.
     •	 Pick-up a child from school
     •	 Enroll a child in school
     •	 Obtain a child’s school records
     •	 Make educational decisions for a child.
     •	 Consent to a child’s travel
     •	 Make medical decisions for a child
10
     Know Your Rights
     Everyone – both documented and undocumented persons – has rights in this country. Talk to everyone in your
     family and household to make sure they know what to do if approached by immigration officials (ICE) or if ICE
     comes to your house.
     •	 Remain calm and do not try to run away. If you do, ICE or the police may use that against you.
     •	 Do not open the door for ICE or any police officer without a signed warrant. You do not need to open the
        door unless an ICE agent can show you a warrant signed by a judge with your correct name and address on it. If
        ICE knocks on your door, ask them to slide the search warrant under the door or show it through a window. If
        ICE or the police do not have this, then you do not have to open the door. Once you open the door, you lose
        certain rights.
     •	 You have the right to remain silent and can refuse to answer ICE’s questions. Say that you want to
        remain silent until you speak with a lawyer. Do not answer any questions, especially about your birth place,
        immigration status or how you entered the U.S. What you say can be used against you later. No matter what,
        do not lie or show false documents. If you have valid immigration documents, show them.
     •	 You have the right to refuse to sign anything before you talk to a lawyer. Do not sign anything you do not
        understand or agree with. That could eliminate your right to speak with a lawyer or have a hearing in front of
        an immigration judge. This may result in you being deported immediately without a hearing.
     •	 If you are detained, you have the right to make a phone call. Make sure to memorize the number of your
        lawyer or someone who can put your plans into place and access all of your important documents. You should
        also have the contact information for your country’s nearest consulate, which may be able to provide assistance.
11
     APPENDIX A
     Hamilton County Juvenile Court
     800 Broadway
     Cincinnati, OH 45202
     (513) 946-9200
     http://www.juvenile-court.org/
     Butler County Juvenile Court
     280 N. Fair Avenue
     Hamilton, OH 45011
     (513) 887-3317
     http://www.butlercountyohio.org/
     juvenilejusticecenter/
     Hamilton County Probate Court
     230 E. 9th Street, 10th Floor
     Cincinnati, OH 45202
     (513) 946-3600
     https://www.probatect.org/
     Butler County Probate Court
     101 High Street
     Hamilton, OH 45011
     (513) 887-3294
     http://www.butlercountyprobatecourt.org/
                       Not Legal Advice. Legal Aid provides this information to help you understand Ohio laws and procedures.
                                 This is not legal advice concerning your case. Lawyer Referral Service 513-381-8359
12            Serving Brown, Butler Clermont, Clinton, Hamilton, Highland & Warren Counties | (513) 241-9400 • lascinti.org
                         POWER OF ATTORNEY FOR CHILD CARE PURPOSES
I, the undersigned parent of _________________________________, child’s date of birth ____/____/____
						Child’s Name
residing at ______________________________________________, in the county of _______________,
					Parent’s Address
State of Ohio, hereby appoint_________________________________residing at____________________
						Petitioner’s Name					Petitioner’s Address
_______________________________________________________, in the county of ______________, State
of Ohio, to be my attorney in fact to exercise any and all of my rights and responsibilities regarding the care,
physical custody, and control of my above named child, except my authority to consent to marriage or adoption
of the child, and to perform all acts necessary in the execution of the rights and responsibilities hereby granted,
as fully as I might do if personally present. I appoint this person to be in loco parentis of my child.
The rights I am transferring under this power of attorney include the ability to enroll the child in school, to
obtain from the school district educational and behavioral information about the child, to consent to all school-
related matters regarding the child, to consent to the child’s travel, and to consent to medical, psychological, or
dental treatment for the child as well as determining the child’s residence.
This transfer does not affect my rights in any future proceedings concerning the custody of the child or the
allocation of the parental rights and responsibilities for the care of the child and does not give the attorney in
fact legal custody of the child. This transfer does not terminate my right to have regular contact with the child. I
hereby certify that I am transferring the rights and responsibilities designated in this power of attorney because
of the following circumstances: I am in detention, about to be detained, incarcerated, or about to be incarcerated,
and therefore am temporarily unable to provide financial support or parental guidance to the child. I have a well-
founded belief that the power
of attorney is in the child’s best interest. In the event that a court of competent jurisdiction does review my child’s
custody and I unable to attend those hearings, I ask the court to consider this my approval of the designated
attorney in fact as the proper, future legal custodian of my child. Both I and my attorney in fact understand that
this document cannot be used for the purposes of transferring schools.
I have made reasonable efforts to locate and provide notice of the creation of this power of attorney to the other
parent and have been unable to locate that parent.
This POWER OF ATTORNEY is valid until the (1) I revoke this POWER OF ATTORNEY in writing and give
no- tice of the revocation to the person designated as attorney in fact or (2) the child ceases to reside with the
person designated as attorney in fact or (3) this POWER OF ATTORNEY is terminated by court order or (4)
the death of the child who is subject of the power of attorney or (5) the death of the person designated as the
attorney in fact.
Signature of Parent________________________________Printed Name of Parent_______________________
Address of Parent_________________________________Phone Number of Parent______________________
County of___________________________________	)
								) ss:
	State of Ohio						)
Before me, a notary in and for the State of Ohio and County of_____________________, personally appeared
___________________________________________whose identity was proven to me by competent, credible,
identification, who deposed, knowingly executed this document to authorize this attorney in fact change her
child’s custody, and stated that the same was her free act and deed this day, 	   /	     / 20 	 .
							
								__________________________________________	
								Notary Public