Ich konnte es leider nicht hochladen, daher kopiert.
CONSENT TO TRAVEL AND SPECIAL POWER OF ATTORNEY
To Whom It May Concern:
This letter is in relation to my child, _____________________________________________ [name of child], who is a citizen of ____________________ and a minor born on _________________________ [specify child’s date of birth]. My child holds a _____ passport with the number _________________________.
I do solemnly swear that I have legal custody of my child and that no pending divorce or child custody proceedings involving my child exist. I do hereby grant full authorization and consent for my child to travel outside of Germany with _________________________ [specify name of adult with whom child will travel], who is the _________________________ [specify adult’s relationship with child] of my child. The purpose of the travel is _________________________ [specify vacation, touring, to visit relatives, to accompany adult on business trip or other reason]. I have approved the following travel plans:
Dates of travel: Destinations/Accommodations:
_________________ ______________________________________
_________________ ______________________________________
I authorize _____________________________________________ [name of adult with whom child will travel] to make any changes whatsoever to the travel plans specified above.
I also authorize ________________________ to make any necessary decisions relating to medical procedures for said child in case of a medical emergency.
Under penalty of perjury under the laws of the state of ______________________, I attest to the truthfulness, accuracy, and validity of the forgoing statement.
____________________________________ ___________________
Custodial Parent's Signature Date
Custodial Parent
Name: __________________________________________________ ______________________
Address: __________________________________________________ ____________________
Home phone: __________________________ Work phone: __________________________
Cell phone: ____________________________ Pager: _______________________________
Email: ________________________________
Additional Contact Information: __________________________________________________ ___
__________________________________________________ _____________________________
CERTIFICATE OF OFFICIAL ATTESTATION
STATE OF __________________
COUNTY OF ________________
Acknowledged before me on ___________________ [date] by __________________________________ [name of principal].
[Notary Seal, if any]:
_______________________________
(Signature of Notarial Officer)
Address and title of Notarial Officer
Das ganze sollte dann notariell beglaubigt werden, also im Beisein eines Notars oder eines zum Führen eines Dienstsiegels berechtigten Beamten unterschrieben werden und die Unterschrift von diesem bestätigt werden (official attestation).
In diesem Dokument wird auch das Recht gegeben, die Erlaubnis zu medizinisch notwendigen Dingen zu geben, falls ein Notfall vorliegt.