Illinois Power of Attorney
This document grants another individual the legal authority to act on behalf of the principal, in accordance with the Illinois Power of Attorney Act (755 ILCS 45/). It is imperative that both parties understand the extent of the powers given and the responsibilities entailed.
Principal Information
Name: ____________________________________________
Address: __________________________________________
City, State, Zip: _________________________________
Phone Number: ____________________________________
Email Address: ___________________________________
Agent Information
Name: ____________________________________________
Address: __________________________________________
City, State, Zip: _________________________________
Phone Number: ____________________________________
Email Address: ___________________________________
Authority Granted
This Power of Attorney document authorizes the Agent named above to perform actions on behalf of the Principal as indicated below:
- Manage financial affairs
- Make health care decisions
- Buy or sell property
- Conduct business transactions
- File tax returns
- Access safety deposit boxes
Specific limitations to the Agent's authority (if any): ______________________________________________________
Term
This Power of Attorney will become effective on______________________(date) and will end on ________________________(date), unless it is revoked earlier by the Principal or by operation of law.
Signature
To make this document legally binding, both the Principal and the Agent must sign and date below in the presence of a notary public.
Principal Signature: _______________________________ Date: _______________
Agent Signature: _________________________________ Date: _______________
Notary Public Acknowledgment
State of Illinois )
County of ___________ )
On _______________ (date), before me, a Notary Public, personally appeared _________________________________________, known to me (or satisfactorily proven) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged that he/she/they executed the same for the purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
Notary Signature: _______________________________
Seal: