Illinois Durable Power of Attorney
This Durable Power of Attorney is executed in accordance with the laws of the State of Illinois.
Principal Information:
- Name: _______________________________
- Address: _____________________________
- City, State, Zip Code: _______________
- Date of Birth: ______________________
Agent Information:
- Name: _______________________________
- Address: _____________________________
- City, State, Zip Code: _______________
- Phone Number: ______________________
Grant of Authority:
The Principal hereby grants the Agent the authority to act on behalf of the Principal in the following matters:
- Real estate transactions
- Financial transactions
- Personal and family maintenance
- Health care decisions
Effective Date:
This Durable Power of Attorney shall become effective immediately and shall remain in effect until revoked by the Principal in writing.
Signature of Principal:
_______________________________
Date: ________________________
Witnesses:
Two witnesses are required for this document. The witnesses must not be named as Agents in this Durable Power of Attorney.
- Witness 1: ______________________ Date: _______________
- Witness 2: ______________________ Date: _______________
Notary Acknowledgment:
State of Illinois
County of ______________________
On this _____ day of ___________, 20____, before me, a Notary Public, personally appeared ______________________, known to me to be the person whose name is subscribed to this instrument, and acknowledged that he/she executed the same.
_______________________________
Notary Public
My Commission Expires: ____________