Illinois Power of Attorney Template
This document serves as a Power of Attorney under Illinois state law. It allows you to designate an agent to make decisions on your behalf regarding financial and medical matters.
Principal Information:
- Name: ____________________________
- Address: ____________________________
- City, State, Zip: ____________________________
- Date of Birth: ____________________________
Agent Information:
- Name: ____________________________
- Address: ____________________________
- City, State, Zip: ____________________________
- Phone Number: ____________________________
Effective Date: This Power of Attorney shall become effective on: ____________________________.
Durability: This Power of Attorney shall remain in effect until revoked or until my death.
Scope of Authority: The agent is authorized to act on my behalf in the following matters:
- Managing financial accounts
- Making healthcare decisions
- Handling real estate transactions
- Filing tax returns
- Other: ____________________________
Signature of Principal: ____________________________
Date: ____________________________
Witness Information:
- Name: ____________________________
- Address: ____________________________
- Signature: ____________________________
- Date: ____________________________
Notary Public:
State of Illinois
County of ____________________________
Subscribed and sworn before me this _____ day of __________, 20__.
Notary Signature: ____________________________
My Commission Expires: ____________________________