Illinois Power of Attorney for a Child
This document serves as a Power of Attorney for a Child, allowing a designated individual to make decisions on behalf of a minor child in accordance with Illinois law.
Principal's Information:
- Full Name: ______________________________
- Address: ______________________________
- City, State, Zip: ______________________________
- Phone Number: ______________________________
Agent's Information:
- Full Name: ______________________________
- Address: ______________________________
- City, State, Zip: ______________________________
- Phone Number: ______________________________
Child's Information:
- Full Name: ______________________________
- Date of Birth: ______________________________
Authority Granted:
The Principal grants the Agent the authority to make decisions regarding the following:
- Medical care and treatment.
- Educational decisions.
- Travel arrangements.
- Any other decisions necessary for the child's well-being.
Effective Date:
This Power of Attorney shall become effective on the date signed and shall remain in effect until revoked by the Principal.
Signatures:
By signing below, the Principal affirms that they understand the powers granted to the Agent and that this document is executed voluntarily.
Principal's Signature: ______________________________ Date: ______________________________
Agent's Signature: ______________________________ Date: ______________________________
Witnesses:
This document must be witnessed by two individuals who are not related to the Principal or Agent.
Witness 1 Signature: ______________________________ Date: ______________________________
Witness 2 Signature: ______________________________ Date: ______________________________