Illinois Power of Attorney Template
This Power of Attorney document, authorized under Illinois law, allows you to appoint someone to act on your behalf in a variety of matters. Please fill in the blanks with your information as necessary.
Principal Information:
- Name: ____________________________________________
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- City, State, Zip Code: ________________________________
- Date of Birth: ______________________________________
Agent Information:
- Name: ____________________________________________
- Address: ____________________________________________
- City, State, Zip Code: ________________________________
- Phone Number: ______________________________________
Powers Granted: The Principal hereby grants the Agent the authority to act in the Principal’s name in the following matters:
- Real estate transactions
- Banking transactions
- Healthcare decisions
- Tax-related matters
- Legal and contractual agreements
Effective Date: This Power of Attorney shall be effective immediately or upon the occurrence of a specified event (please state the event): ____________________________________________.
Revocation: This Power of Attorney may be revoked by the Principal at any time, as long as the revocation is in writing and delivered to the Agent.
Signature:
Principal's Signature: ________________________________
Date: _______________
Witnesses: (Two witnesses are required)
1. Witness Signature: ________________________________
Name: ____________________________________________
2. Witness Signature: ________________________________
Name: ____________________________________________
Notary Acknowledgment:
State of Illinois
County of ________________
Subscribed, sworn to, and acknowledged before me this ____ day of __________, 20__ by ___________________________________.
Notary Public Signature: ____________________________
My commission expires: _______________________________