H.F. 721 Section 1. NEW SECTION . 633F.1 Definitions. 1 1. “Agent” means a person granted authority to act for a 2 parent, guardian, or legal custodian under a power of attorney 3 created under this chapter. 4 2. “Child” means a person under eighteen years of age. 5 3. “Power of attorney” means a writing that grants authority 6 to an agent to act in the place of a parent, guardian, or legal 7 custodian regarding the care or custody of a child. 8 Sec. 2. NEW SECTION . 633F.2 Power of attorney —— temporary 9 delegation of parental authority. 10 1. A parent, guardian, or legal custodian of a child, by a 11 properly executed power of attorney, may delegate to another 12 person any authority regarding the care or custody of the child 13 except for any of the following powers: 14 a. The power to consent to the child’s marriage. 15 b. The power to consent to the child’s adoption. 16 c. The power to consent to the performance or inducement of 17 an abortion on or for the child. 18 d. The power to consent to the termination of the parental 19 rights of a parent of the child. 20 e. The power to transfer the power of attorney to another 21 person unless the other person is designated as a successor 22 agent in the power of attorney. 23 2. A power of attorney executed under this chapter must be 24 signed by all parents, guardians, and legal custodians. The 25 power of attorney must be acknowledged before a notary public 26 or other individual authorized by law to take acknowledgments. 27 An agent named in the power of attorney shall not notarize the 28 principal’s signature. An acknowledged signature on a power of 29 attorney is presumed to be genuine. 30 3. A parent, guardian, or legal custodian of the child shall 31 have the authority to revoke or terminate a power of attorney 32 created under this chapter at any time by giving notice of the 33 revocation in writing to the agent. 34 4. A power of attorney created under this chapter shall be 35 -1- LSB 1251HV (3) 88 hb/rh 1/ 9

H.F. 721 for a period of time not to exceed three months. A parent, 1 guardian, or legal custodian of the child may execute a new 2 power of attorney for an additional period of three months, but 3 in no case shall a power of attorney created under this chapter 4 be valid for more than six months. If a parent, guardian, or 5 legal custodian revokes or terminates the power of attorney, 6 the child shall be returned to the care and custody of the 7 parent, guardian, or legal custodian within twenty-four hours 8 of the date of the revocation or termination. 9 5. An agent shall exercise parental or legal authority on a 10 continuous basis without compensation for the duration of the 11 power of attorney and shall not be considered to be a foster 12 parent subject to licensure by the department of human services 13 pursuant to chapter 237. 14 6. A power of attorney executed under this chapter by a 15 parent, guardian, or legal custodian shall not constitute 16 abandonment, abuse, or neglect of the child under chapter 232 17 by the parent, guardian, or legal custodian unless the parent, 18 guardian, or legal custodian fails to take custody of the child 19 upon the expiration of the power of attorney. 20 7. A power of attorney executed under this chapter by a 21 parent, guardian, or legal custodian shall not be valid if the 22 purpose is to avoid the filing of a child in need of assistance 23 petition. 24 8. This chapter shall not apply to a power of attorney 25 created pursuant to section 598C.204. 26 Sec. 3. NEW SECTION . 633F.3 Power of attorney temporary 27 delegation of parental authority —— form. 28 A document substantially in the following form may be used 29 to create a power of attorney temporary delegation of parental 30 authority that has the meaning and effect prescribed by this 31 chapter: 32 POWER OF ATTORNEY TEMPORARY DELEGATION OF PARENTAL AUTHORITY 33 FORM 34 1. POWER OF ATTORNEY 35 -2- LSB 1251HV (3) 88 hb/rh 2/ 9

H.F. 721 This power of attorney authorizes another person (your 1 agent) to make decisions concerning your child or children for 2 you (the principal). Your agent will be able to make decisions 3 and act with respect to your child or children. The meaning 4 of authority over the child or children listed on this form 5 is explained in the Power of Attorney temporary delegation of 6 parental authority, Iowa Code chapter 633F. This power of 7 attorney does not grant the agent the power to consent to a 8 child’s marriage or adoption, to the performance or inducement 9 of an abortion on or for a child, or to the termination of 10 parental rights of a parent of a child or to the transfer of the 11 power of attorney to a person other than to a person designated 12 as a successor agent in this power of attorney. 13 You should select someone you trust to serve as your agent. 14 Your agent is not entitled to compensation unless you state 15 otherwise in the optional Special Instructions. 16 This form provides for designation of one agent. If you 17 wish to name more than one agent, you may name a coagent in the 18 optional Special Instructions. Coagents must act by majority 19 rule unless you provide otherwise in the optional Special 20 Instructions. 21 If your agent is unable or unwilling to act for you, your 22 power of attorney will end unless you have named a successor 23 agent. You may also name a second successor agent. 24 This power of attorney becomes effective immediately upon 25 signature and acknowledgment unless you state otherwise in the 26 optional Special Instructions. 27 If you have questions about this power of attorney or the 28 authority you are granting to your agent, you should seek legal 29 advice before signing this form. 30 DESIGNATION OF AGENT 31 I _________________________ (name of principal) name the 32 following person as my agent: 33 Name of Agent ____________________________________________ 34 Agent’s Address __________________________________________ 35 -3- LSB 1251HV (3) 88 hb/rh 3/ 9

H.F. 721 Agent’s Telephone Number _________________________________ 1 DESIGNATION OF SUCCESSOR AGENT(S) (OPTIONAL) 2 If my agent is unable or unwilling to act for me, I name as 3 my successor agent: 4 Name of Successor Agent __________________________________ 5 Successor Agent’s Address ________________________________ 6 Successor Agent’s Telephone Number _______________________ 7 If my successor agent is unable or unwilling to act for me, I 8 name as my second successor agent: 9 Name of Second Successor Agent ___________________________ 10 Second Successor Agent’s Address _________________________ 11 Second Successor Agent’s Telephone Number ________________ 12 GRANT OF GENERAL AUTHORITY 13 I grant my agent and any successor agent general authority to 14 act for me with respect to my child or my children as defined 15 in the Power of Attorney Temporary Delegation of Parental 16 Authority, Iowa Code chapter 633F. 17 SPECIAL INSTRUCTIONS 18 You may give special instructions including the name and 19 date of birth of the child on the following lines: 20 ___________________________________________________________ 21 ___________________________________________________________ 22 ___________________________________________________________ 23 ___________________________________________________________ 24 ___________________________________________________________ 25 ___________________________________________________________ 26 ___________________________________________________________ 27 ___________________________________________________________ 28 ___________________________________________________________ 29 ___________________________________________________________ 30 ___________________________________________________________ 31 __________________________________________________________. 32 EFFECTIVE DATE 33 This power of attorney is effective immediately upon 34 signature and acknowledgment unless I have stated otherwise in 35 -4- LSB 1251HV (3) 88 hb/rh 4/ 9

H.F. 721 the optional Special Instructions. 1 RELIANCE ON THIS POWER OF ATTORNEY 2 Any person, including my agent, may rely upon the validity of 3 this power of attorney or a copy of it unless that person knows 4 it has terminated or is invalid. 5 SIGNATURE AND ACKNOWLEDGMENT 6 _____________________________ _________________________ 7 Your Signature Date 8 _____________________________ 9 Your Name Printed 10 _____________________________ 11 _____________________________ 12 Your Address 13 _____________________________ 14 Your Telephone Number 15 State of ____________________ 16 County of ___________________ 17 This document was acknowledged before me on _______________ 18 (date), by __________________________ (name of principal) 19 _____________________________ (Seal, if any) 20 Signature of Notary 21 My commission expires ________________ 22 This document prepared by 23 ___________________________________________________________ 24 ___________________________________________________________ 25 2. IMPORTANT INFORMATION FOR AGENT 26 AGENT’S DUTIES 27 When you accept the authority granted under this power of 28 attorney, a special legal relationship is created between the 29 principal and you. This relationship imposes upon you legal 30 duties that continue until you resign or the power of attorney 31 is terminated or revoked. You must do all of the following: 32 Act in good faith. 33 Do nothing beyond the authority granted in this power of 34 attorney. 35 -5- LSB 1251HV (3) 88 hb/rh 5/ 9

H.F. 721 Disclose your identity as an agent whenever you act for the 1 principal by writing or printing the name of the principal and 2 signing your own name as agent in the following manner: 3 _______________________ (principal’s name) by 4 _______________________ (your signature) as Agent 5 Unless the Special Instructions in this power of attorney 6 state otherwise, you must also do all of the following: 7 Act loyally for the child’s or children’s and principal’s 8 benefit. 9 Avoid conflicts that would impair your ability to act in the 10 child or children’s and principal’s best interest. 11 Act with care, competence, and diligence. 12 TERMINATION OF AGENT’S AUTHORITY 13 You must stop acting on behalf of the principal if you learn 14 of any event that terminates this power of attorney or your 15 authority under this power of attorney. Events that terminate 16 a power of attorney or your authority to act under a power of 17 attorney include any of the following: 18 The principal’s revocation of the power of attorney or your 19 authority. 20 The occurrence of a termination event stated in the power of 21 attorney. 22 The purpose of the power of attorney is fully accomplished. 23 The time period specified in the power of attorney has 24 expired. 25 The three-month time period permitted under Iowa Code 26 chapter 633F has expired. 27 The three-month extension time period permitted under Iowa 28 Code chapter 633F has expired. 29 LIABILITY OF AGENT 30 The meaning of the authority granted to you is defined in the 31 Power of Attorney Temporary Delegation of parental authority, 32 Iowa Code chapter 633F. If you violate the Power of Attorney 33 Temporary Delegation of parental authority, Iowa Code chapter 34 633F, or act outside the authority granted, you may be liable 35 -6- LSB 1251HV (3) 88 hb/rh 6/ 9

H.F. 721 for any damages caused by your violation. 1 If there is anything about this document or your duties that 2 you do not understand, you should seek legal advice. 3 Sec. 4. NEW SECTION . 633F.4 Agent’s certification —— 4 optional form. 5 The following optional form may be used by an agent to 6 certify facts concerning a power of attorney: 7 IOWA STATUTORY POWER OF ATTORNEY TEMPORARY DELEGATION OF 8 PARENTAL AUTHORITY AGENT’S CERTIFICATION FORM 9 AGENT’S CERTIFICATION OF VALIDITY OF POWER OF ATTORNEY AND 10 AGENT’S AUTHORITY 11 State of _________________________ 12 County of ______________________ 13 I, ______________________________ (name of agent), certify 14 under penalty of perjury that ______________________________ 15 (name of principal) granted me authority as an agent 16 or successor agent in a power of attorney dated 17 _____________________. 18 I further certify all of the following to my knowledge: 19 The principal is alive and has not revoked the power of 20 attorney or the Power of Attorney and my authority to act under 21 the Power of Attorney have not terminated. 22 If the power of attorney was drafted to become effective 23 upon the happening of an event or contingency, the event or 24 contingency has occurred. 25 If I was named as a successor agent, the prior agent is no 26 longer able or willing to serve. 27 __________________________________________________________ 28 __________________________________________________________ 29 __________________________________________________________. 30 (Insert other relevant statements) 31 SIGNATURE AND ACKNOWLEDGMENT 32 _____________________________ _________________________ 33 Agent’s Signature Date 34 _____________________________ 35 -7- LSB 1251HV (3) 88 hb/rh 7/ 9

H.F. 721 Agent’s Name Printed 1 _____________________________ 2 _____________________________ 3 Agent’s Address 4 _____________________________ 5 Agent’s Telephone Number 6 This document was acknowledged before me on _______________ 7 (date), by __________________________ (name of agent) 8 _____________________________ (Seal, if any) 9 Signature of Notary 10 My commission expires ________________ 11 This document prepared by 12 ___________________________________________________________ 13 ___________________________________________________________ 14 EXPLANATION 15 The inclusion of this explanation does not constitute agreement with 16 the explanation’s substance by the members of the general assembly. 17 This bill relates to the temporary delegation of parental 18 authority by the parent, guardian, or legal custodian of a 19 child. 20 The bill provides that a parent, guardian, or legal 21 custodian of a child, by a properly executed power of attorney, 22 may delegate to another person any powers regarding the care 23 or custody of the child except the power to consent to the 24 child’s marriage, the power to consent to the child’s adoption, 25 the power to consent to the performance or inducement of an 26 abortion on or for the child, the power to consent to the 27 termination of the parental rights of a parent of the child, 28 and the power to transfer the power of attorney to another 29 person unless the other person is designated as a successor 30 agent in the power of attorney. A power of attorney executed 31 under the bill must be signed by all parents, guardians, and 32 legal custodians of a child and must be properly acknowledged 33 by a notary. A parent, guardian, or legal custodian shall 34 have the authority to revoke or terminate a power of attorney 35 -8- LSB 1251HV (3) 88 hb/rh 8/ 9

H.F. 721 created under the bill at any time. 1 A power of attorney created under the bill shall be for 2 a period of time not to exceed three months. The parent, 3 guardian, or legal custodian of the child may execute a new 4 power of attorney for an additional period of three months, but 5 a power of attorney created under the bill cannot exceed six 6 months. If the parent, guardian, or legal custodian revokes or 7 terminates the power of attorney, the child shall be returned 8 to the care and custody of the parent, guardian, or legal 9 custodian within 24 hours of the date of the revocation or 10 termination. 11 An agent (person granted authority to act for a parent, 12 guardian, or legal custodian under a power of attorney 13 created in the bill) is required to exercise parental or legal 14 authority on a continuous basis without compensation for the 15 duration of the power of attorney and shall not be considered 16 to be a foster parent subject to licensure by the department 17 of human services pursuant to Code chapter 237 (child foster 18 care facilities). A power of attorney executed under the bill 19 by a parent, guardian, or legal custodian shall not constitute 20 abandonment, abuse, or neglect of the child under Code chapter 21 232 by the parent, guardian, or legal custodian unless the 22 parent, guardian, or legal custodian fails to take custody of 23 the child or to execute a subsequent power of attorney upon the 24 expiration of the power of attorney. 25 A power of attorney created under the bill is not valid 26 if the purpose is to avoid the filing of a child in need of 27 assistance petition. 28 The bill does not apply to a power of attorney created 29 pursuant to Code section 598C.204 (power of attorney under the 30 uniform deployed parents custody and visitation Act). 31 The bill provides a form for a temporary delegation of a 32 parental authority power of attorney. 33 -9- LSB 1251HV (3) 88 hb/rh 9/ 9