Printable Power of Attorney for a Child Template for Illinois State

The Illinois Power of Attorney for a Child form is a legal document that allows a parent or guardian to designate another individual to make decisions on behalf of their child. This arrangement can be particularly useful in situations where the parent is unable to care for the child temporarily, such as during travel or medical emergencies. For those interested in ensuring their child's well-being, filling out this form is a crucial step; click the button below to get started.

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Printable Power of Attorney for a Child Template for Illinois State

Table of Contents

The Illinois Power of Attorney for a Child form is a crucial legal document that allows a parent or legal guardian to designate another adult to make decisions on behalf of their minor child. This form is particularly useful in situations where parents are unable to care for their child due to travel, illness, or other circumstances. The appointed adult, often referred to as the agent, can make decisions regarding the child's education, healthcare, and general welfare. Importantly, this power can be limited to specific areas or extend to all aspects of the child's life, depending on the parent's wishes. The form requires the signatures of both the parent and the agent, and it must be notarized to ensure its validity. Additionally, parents can specify the duration of the power granted, which can be temporary or more long-term, providing flexibility to accommodate various situations. Understanding the implications and responsibilities associated with this form is essential for parents seeking to ensure their child's well-being in their absence.

Example - Illinois Power of Attorney for a Child Form

Illinois Power of Attorney for a Child

This document grants temporary authority to an individual chosen by the parent(s) or legal guardian(s) to make decisions on behalf of their child in accordance with the Illinois Power of Attorney Act (755 ILCS 45/). By completing this form, the appointed person (agent) will be able to act on the parent’s or guardian's behalf in matters concerning the child’s education, healthcare, and other welfare needs.

Instructions: Complete all fields with the appropriate information.

Part 1: Child Information

Full Name of Child: ___________________________
Date of Birth: ___________________________ (Month/Day/Year)
Address: ______________________________________
City: __________________ State: IL Zip Code: ________

Part 2: Parent/Guardian Information

Full Name of Parent/Guardian: ___________________________
Relationship to Child: ___________________________
Contact Number: ___________________________
Address (if different from child): ___________________________
City: __________________ State: IL Zip Code: ________

Part 3: Agent Information

Full Name of Agent: ___________________________
Relationship to Child: ___________________________
Contact Number: ___________________________
Address: ______________________________________
City: __________________ State: IL Zip Code: ________

Part 4: Powers Granted

The parent(s)/guardian(s) grant the following powers to the agent:

Authority to make decisions concerning the education of the named child, including but not limited to, enrollment in or withdrawal from any institution, participation in any particular curriculum, and access to any records related to the child.
Authority to make healthcare decisions for the child, including but not limited to, consent to any medical, dental, and mental health treatments, access to health records, and decisions regarding end-of-life care.
Authority to make decisions concerning the child’s social and extracurricular activities, travel, and residence.

Part 5: Duration

This Power of Attorney shall become effective on __________________ (Month/Day/Year) and, unless earlier revoked by the undersigned, shall remain in effect until __________________ (Month/Day/Year).

Part 6: Signature

This Power of Attorney must be signed by the parent(s) or legal guardian(s) in the presence of two witnesses and notarized. The agent cannot serve as a witness.

Signature of Parent/Guardian: ___________________________ Date: ________________
Printed Name: ___________________________
Signature of Second Parent/Guardian (if applicable): ___________________________ Date: ________________
Printed Name: ___________________________
Signature of Witness #1: ___________________________ Date: ________________
Printed Name: ___________________________
Signature of Witness #2: ___________________________ Date: ________________
Printed Name: ___________________________
Signature of Notary Public: ___________________________ Date: ________________
Commission Expiration: ___________________________

▼ PDF

PDF Form Properties

Fact Name	Description
Purpose	The Illinois Power of Attorney for a Child form allows a parent or guardian to delegate parental authority to another adult for a specified period.
Governing Law	This form is governed by the Illinois Compiled Statutes, specifically 755 ILCS 45/1-1 et seq.
Duration	The authority granted through this form can be effective for up to one year, unless revoked earlier.
Eligibility	Any adult can be designated as the agent, provided they are willing and able to act in the best interest of the child.

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