2006 New York Code - Form Of Designation.

 
    §   5-1552.  Form  of  designation.  1.  Designations  in  general.  A
  designation of a person in parental  relation  pursuant  to  this  title
  shall  be in writing and shall include: the name of the parent, the name
  of the designee, the name of each minor  or  incapacitated  person  with
  respect  to  whom  such designation is made, the parent's signature, and
  the date of such signature. The designation may specify a period of time
  less than six months for which such designation shall  be  valid  unless
  earlier revoked by such parent pursuant to section 5-1554 of this title,
  provided  that  any  designation specifying a period of more than thirty
  days shall also conform to the provisions of  subdivision  two  of  this
  section.
    2.  Designations for more than thirty days. A designation specifying a
  period of more than thirty days  shall  also  include:  an  address  and
  telephone  number  where  the  parent  can  be  reached,  an address and
  telephone number where the designee can be reached, the date of birth of
  each minor or incapacitated person with respect to whom such designation
  is  made,  the  date  or  contingent  event  on  which  the  designation
  commences,  the written consent of the designee to such designation, and
  a  statement  that  there  is  no  prior  order  of  any  court  in  any
  jurisdiction currently in effect prohibiting such parent from making the
  designation.  A designation specifying a period of more than thirty days
  shall be notarized.
    3. Designations not specifying a time period. If  no  time  period  is
  specified  in  a  designation,  it  shall  be valid until the earlier of
  revocation or the expiration of thirty days from the date  of  signature
  if  the designation does not meet the requirements of subdivision two of
  this section, or six months from  the  date  of  commencement  specified
  therein  if the designation meets the requirements of subdivision two of
  this section.