AB581: Bill Text

AB581,9,13 Authorized by s. 48.979, Wis. Stats.

AB581,9,14 NAME(S) OF CHILD(REN)

AB581,9,16 This power of attorney is for the purpose of providing for the care and custody of:

AB581,9,17 Name, address, and date of birth of child ....

AB581,9,18 Name, address, and date of birth of child ....

AB581,9,19 Name, address, and date of birth of child ....

AB581,9,20 DELEGATION OF POWER TO AGENT

AB581,9,25 I, .... (name and address of parent), state that I have legal custody of the child(ren) named above. (Only a parent who has legal custody may use this form.) A parent may not use this form to delegate parental powers regarding a child who is subject to the jurisdiction of the juvenile court under s. 48.13, 48.14, 938.12, 938.13, or 938.14, Wis. Stats.

AB581,10,1 I delegate my parental power to:

AB581,10,2 Name of agent ....

AB581,10,3 Agent's address ....

AB581,10,4 Agent's telephone number(s) ....

AB581,10,5 Agent's e-mail address ....

AB581,10,6 Relationship of agent to child(ren) ....

AB581,10,7 The parental power I am delegating is as follows:

AB581,10,8 FULL

AB581,10,10 (Check if you want to delegate full parental power regarding the care and custody of the child(ren) named above.)

AB581,10,12 .... Full parental power regarding the care and custody of the child(ren) named above

AB581,10,13 PARTIAL

AB581,10,15 (Check each subject over which you want to delegate your parental power regarding the child(ren) named above.)

AB581,10,16 .... The power to consent to all health care; or

AB581,10,17 .... The power to consent to only the following health care:

AB581,10,19 .... Ordinary or routine health care, excluding major surgical procedures, extraordinary procedures, and experimental treatment

AB581,10,20 .... Emergency blood transfusion

AB581,10,21 .... Dental care

AB581,10,22 .... Disclosure of health information about the child(ren)

AB581,10,23 .... The power to consent to educational and vocational services

AB581,10,24 .... The power to consent to the employment of the child(ren)

AB581,11,2 .... The power to consent to the disclosure of confidential information, other than health information, about the child(ren)

AB581,11,3 .... The power to provide for the care and custody of the child(ren)

AB581,11,5 .... The power to consent to the child(ren) obtaining a motor vehicle operator's license

AB581,11,6 .... The power to travel with the child(ren) outside the state of Wisconsin

AB581,11,7 .... The power to obtain substitute care, such as child care, for the child(ren)

AB581,11,11 .... Other specifically delegated powers or limits on delegated powers (Fill in the following space or attach a separate sheet describing any other specific powers that you wish to delegate or any limits that you wish to place on the powers you are delegating.) ....

AB581,11,14 This delegation of parental powers does not deprive a custodial or noncustodial parent of any of his or her powers regarding the care and custody of the child, whether granted by court order or force of law.

AB581,11,21 THIS DOCUMENT MAY NOT BE USED TO DELEGATE THE POWER TO CONSENT TO THE MARRIAGE OR ADOPTION OF THE CHILD(REN), THE PERFORMANCE OR INDUCEMENT OF AN ABORTION ON OR FOR THE CHILD(REN), THE TERMINATION OF PARENTAL RIGHTS TO THE CHILD(REN), THE ENLISTMENT OF THE CHILD(REN) IN THE U.S. ARMED FORCES OR TO PLACE THE CHILD(REN) IN A FOSTER HOME, GROUP HOME, OR INPATIENT TREATMENT FACILITY.

AB581,11,23 EFFECTIVE DATE AND TERM OF THIS DELEGATION

AB581,12,8 This Power of Attorney takes effect on .... and will remain in effect until .... If no termination date is given or if the termination date given is more than one year after the effective date of this Power of Attorney, this Power of Attorney will remain in effect for a period of one year after the effective date, but no longer. If the termination date given is more than one year after the effective date of this Power of Attorney, this Power of Attorney must be approved by the juvenile court. This Power of Attorney may be revoked in writing at any time by a parent who has legal custody of the child(ren) and such a revocation invalidates the delegation of parental powers made by this Power of Attorney, except with respect to acts already taken in reliance on this Power of Attorney.

AB581,12,9 SIGNATURE(S) OF PARENT(S)

AB581,12,10 Signature of parent ....   Date ....

AB581,12,11 Parent's name printed ....

AB581,12,12 Parent's address ....

AB581,12,13 Parent's telephone number ....

AB581,12,14 Parent's e-mail address ....

AB581,12,15 Signature of parent ....   Date ....

AB581,12,16 Parent's name printed ....

AB581,12,17 Parent's address ....

AB581,12,18 Parent's telephone number ....

AB581,12,19 Parent's e-mail address ....

AB581,12,20 WITNESSING OF SIGNATURE(S) (OPTIONAL)

AB581,12,21 State of ....

AB581,12,22 County of ....

AB581,12,23 This document was signed before me on .... (date) by .... (name(s) of parent(s)).

AB581,12,24 Signature of notary ....

AB581,12,25 My commission expires: ....

AB581,13,1 STATEMENT OF AGENT

AB581,13,8 I, .... (name and address of agent), understand that .... (name(s) of parent(s)) has (have) delegated to me the powers specified in this Power of Attorney regarding the care and custody of .... (name(s) of child(ren)). I further understand that this Power of Attorney may be revoked in writing at any time by a parent who has legal custody of .... (name(s) of child(ren)). I hereby declare that I have read this Power of Attorney, understand the powers delegated to me by this Power of Attorney, am fit, willing, and able to undertake those powers, and accept those powers.

AB581,13,9 Agent's signature ....   Date ....

AB581,13,10 APPENDIX

AB581,13,12 (Here the parent(s) may indicate where they may be located during the term of the Power of Attorney if different from the address(es) set forth above.)

AB581,13,13 .... I can be located at:

AB581,13,14 Address(es) ....

AB581,13,15 Telephone number(s) ....

AB581,13,16 E-mail address(es) ....

AB581,13,17 .... Or, by contacting:

AB581,13,18 Name ....

AB581,13,19 Address ....

AB581,13,20 Telephone number ....

AB581,13,21 E-mail address ....

AB581,13,22 .... Or, I cannot be located

AB581,11 Section 11. 948.25 of the statutes is created to read:

AB581,14,3 948.25 Unauthorized interstate placements of children. (1) Any person who sends a child out of this state, brings a child into this state, or causes a child to be sent out of this state or brought into this state for the purpose of permanently transferring physical custody of the child to a person who is not a relative of the child is guilty of a Class A misdemeanor.

AB581,14,4 (2) Subsection (1) does not apply to any of the following:

AB581,14,5 (a) A placement of a child that is authorized under s. 48.98, 48.988, or 48.99.

AB581,14,7 (b) A placement of a child that is approved by a court of competent jurisdiction of the sending state or receiving state.

AB581,12 Section 12. Nonstatutory provisions.

AB581,14,12 (1) Study of adoption disruption and dissolution. The joint legislative council is requested to study adoption disruption and dissolution in this state. If the joint legislative council undertakes such a study, the joint legislative council shall do all of the following:

AB581,14,15 (a) Study the extent of adoption disruption and dissolution in this state and the efforts by the department of children and families, counties, and child welfare agencies to prevent such disruption and dissolution.

AB581,14,16 (b) Recommend legislation to accomplish all of the following:

AB581,14,17 1. Define adoption disruption and adoption dissolution.

AB581,14,18 2. Prevent adoption disruption and adoption dissolution in this state.

AB581,14,22 3. Require the department of children and families, county departments of human services or social services that are authorized to place children for adoption, and child welfare agencies that are licensed to place children for adoption to track and report on disrupted or dissolved adoptions.

AB581,14,24 (c) Consider legislative options to prepare prospective adoptive parents for adoption and to support adoptive parents after an adoption.

AB581,15,2 (d) Submit its findings, conclusions, and recommendations to the 2015 legislature when it commences.

AB581,13 Section 13. Initial applicability.

AB581,15,7 (1) Advertising related to adoption or other permanent physical placements of a child. The treatment of section 48.825 (1) (a), (2) (a), (b), and (c), and (3) (a) and (e) of the statutes first applies to advertising placed or posted on the effective date of this subsection.

AB581,15,8 (End)