Illinois Durable Power of Attorney Template
This Durable Power of Attorney is established pursuant to the Illinois Power of Attorney Act (755 ILCS 45/), allowing a designated person, known as the Agent, to make decisions on behalf of the Principal.
Principal Information
Full Name: ____________________________________________________
Address: _______________________________________________________
City: ____________________ State: Illinois Zip: ___________
Agent Information
Full Name: ____________________________________________________
Address: _______________________________________________________
City: ____________________ State: Illinois Zip: ___________
Alternate Agent Information (Optional)
If the original Agent is unable or unwilling to perform, an Alternate Agent may act instead.
Full Name: ____________________________________________________
Address: _______________________________________________________
City: ____________________ State: Illinois Zip: ___________
Powers Granted
The Principal grants the Agent the following powers, which shall remain effective even upon the incapacity of the Principal:
- Real Estate Transactions
- Banking and Financial Transactions
- Health Care Decisions (Subject to the Illinois Health Care Surrogate Act, if applicable)
- Personal and Family Maintenance
- Government Benefits
- Retirement Plan Transactions
Special Instructions
Any special instructions or limitations regarding the granted powers should be detailed below:
______________________________________________________________________________
______________________________________________________________________________
Effective Date and Durability
This Power of Attorney shall become effective on Date: ____________________ and shall remain in effect indefinitely unless a specific expiration date is set forth below.
Expiration Date (Optional): __________________________________________
Signature
In agreement to the above-stated terms, the Principal and Agent, along with a witness or Notary Public, shall sign below:
Principal's Signature: ___________________________________ Date: ________________
Agent's Signature: _____________________________________ Date: ________________
Witness or Notary Public Signature: ________________________ Date: ________________