Free · Private · Print and sign in front of a notary

Build your emergency kit: the papers that let someone you trust act for you

If you are detained, someone has to be able to pick up your children, talk to their school, and pay your rent — legally. This kit turns what you already know into two signable documents: a power of attorney for the care of your children and a limited financial power of attorney. Fill it in, print it, and sign it in front of a notary — not before. It takes about 20 minutes.

Making this kit is not giving up, and a power of attorney does not give away custody of your children. It is a tool you control: it starts when you say, and you can revoke it in writing at any time.

By default nothing is saved. If you choose Save on this device, it stays only on this device.

This is a preparedness template, not legal advice. Power-of-attorney law varies by state, and some states require their own statutory forms — in Florida, ask a lawyer about a Designation of Health Care Surrogate for a Minor (Fla. Stat. § 765.2035). Have a licensed attorney or a DOJ-accredited representative review these documents before you rely on them. A notary verifies identity and signatures; a notary cannot give legal advice. Free legal help: Find Help.

The printed documents are in English on purpose — banks, schools and courts require English documents. Help in Kreyòl and Español is coming to this page; the documents themselves will stay English.

Losing TPS is not a deportation order

TPS for Haiti and Syria was terminated effective July 27, 2026, and TPS work permits expired the same day. That is not an automatic deportation order. Removal requires a legal process, and in that process you have rights — the ones on this card.

A · Who you are

Exactly as it appears on your ID — the notary will compare it.

Full legal name Other names you have used (if any)

Date of birth Country of birth

A-Number (optional) Sensitive. Leave blank if you are not sure you want it on paper. Street address, city, state, ZIP Phone

B · Your children

List each child this kit should cover. Leave extra rows blank.

Child 1 Child’s full name

Date of birth School (name and city)

Child 2 Child’s full name

Date of birth School (name and city)

Child 3 Child’s full name

Date of birth School (name and city)

Child 4 Child’s full name

Date of birth School (name and city)

C · The person you trust to act for you (your “agent”)

Choose someone you trust completely — ideally a U.S. citizen or green-card holder who is not at risk themselves. Talk to them first: they must be willing.

Agent’s full legal name

Relationship to you Agent’s phone

Agent’s address

Backup agent (if the first cannot act)

Backup agent’s full legal name Backup agent’s phone

D · Powers over your children

Check only what you want to grant. Unchecked lines print as unchecked, so it is clear what you did NOT grant.

Enroll the child in school and receive school records Consent to medical and dental care Travel with the child inside the United States Provide day-to-day care and housing

When does this power start?

Immediately, when I sign it Only if I am detained by immigration authorities or removed from the United States End date (optional) Leave blank to remain in effect until you revoke it in writing.

E · Money and property powers

Check only what you want to grant.

Deposit, withdraw and manage funds at my bank or credit union Pay rent and deal with my landlord or lease Manage, move or sell my vehicle Receive and open my mail Manage benefits for my children (school meals, WIC, Medicaid) File my tax returns and receive refunds

When does this power start?

Immediately, when I sign it Only if I am detained by immigration authorities or removed from the United States Limits (optional) Anything your agent may NOT do — for example, “may not sell the car.”

F · The signing appointment

Do not sign at home. The documents are only valid with your wet-ink signature made in front of the notary. Bring unexpired government photo ID, and bring two adult witnesses for the children’s power of attorney (the agent should not be a witness).

State where you will sign County

Planned signing date

Bring to the appointment

This packet, printed, UNSIGNED
Unexpired government photo ID (passport, license, or state ID)
Two adult witnesses who are not the agent
Your agent, if possible — their contact details get verified once, in person

Not saved on this device

Printing sends nothing anywhere — it goes straight from your device to your printer. Print two copies: one signs at the notary, one stays blank as a spare.

Family Emergency Kit — signing instructions

This packet contains two documents prepared by the family named below for execution before a notary public. Sign ONLY in the notary’s presence.

Sign each document in front of the notary — never before.
The children’s power of attorney also needs two adult witnesses who are not the agent.
After signing: give one copy to the agent, one to the backup agent, tell the school, and keep the original where your family plan says documents live.
This power of attorney does not transfer custody. The parent may revoke it in writing at any time.

In this packet

1. Document 1 — Power of Attorney for the Care of Minor Child(ren)
2. Document 2 — Limited Financial Power of Attorney

Prepared as a family-preparedness template; review by a licensed attorney is recommended before reliance. Not legal advice.

Document 1 — Power of Attorney for the Care of Minor Child(ren)

I, (also known as ), date of birth , A-Number , residing at , am a parent or legal guardian of the child(ren) listed below. I appoint the agent named below as my attorney-in-fact to act for me in matters concerning each listed child, limited to the powers checked below.

Child(ren) covered by this document

Agent (attorney-in-fact)

· ·

Backup agent (if the agent above cannot act): ·

Powers granted (checked = granted; unchecked = NOT granted)

☐ Enroll the child in school and receive school records
☐ Consent to medical and dental care
☐ Travel with the child inside the United States
☐ Provide day-to-day care and housing

When this document takes effect

☐ Immediately upon my signing
☐ Only if I am detained by immigration authorities or removed from the United States

Unless revoked earlier in writing, this document ends on:

This document does not transfer legal custody of any child. I may revoke this power of attorney in writing at any time.

Signature of parent / principal
Date
Printed name

Witnesses (sign in the notary’s presence)

Witness 1 — signature / printed name / address

Witness 2 — signature / printed name / address

Notary acknowledgment

State of · County of

This record was acknowledged before me on (date) by .

Signature of notary public
Notary’s printed name
Commission number
Commission expires

SEAL

The notary may substitute the acknowledgment wording required by their state.

Prepared as a family-preparedness template; review by a licensed attorney is recommended before reliance. Not legal advice.

Document 2 — Limited Financial Power of Attorney

I, , date of birth , A-Number , residing at . I appoint the agent named below as my attorney-in-fact for the LIMITED purposes checked below, and no others.

Agent (attorney-in-fact)

· ·

Backup agent (if the agent above cannot act): ·

Powers granted (checked = granted; unchecked = NOT granted)

☐ Deposit, withdraw and manage funds at my bank or credit union
☐ Pay rent and deal with my landlord or lease
☐ Manage, move or sell my vehicle
☐ Receive and open my mail
☐ Manage benefits for my children (school meals, WIC, Medicaid)
☐ File my tax returns and receive refunds

Limits

When this document takes effect

☐ Immediately upon my signing
☐ Only if I am detained by immigration authorities or removed from the United States

This document does not transfer legal custody of any child. I may revoke this power of attorney in writing at any time.

Signature of parent / principal
Date
Printed name

Notary acknowledgment

State of · County of

This record was acknowledged before me on (date) by .

Signature of notary public
Notary’s printed name
Commission number
Commission expires

SEAL

The notary may substitute the acknowledgment wording required by their state.

Prepared as a family-preparedness template; review by a licensed attorney is recommended before reliance. Not legal advice.

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