Illinois Durable Power of Attorney
This Durable Power of Attorney (the "Document") is created in accordance with the Illinois Power of Attorney Act and grants the appointed Attorney-in-Fact the authority to act on behalf of the Principal.
1. Principal Information:
Name: ___________________________________________
Address: __________________________________________
City, State, Zip: ___________________________________
Phone Number: _____________________________________
2. Attorney-in-Fact Information:
Name: ___________________________________________
Address: __________________________________________
City, State, Zip: ___________________________________
Phone Number: _____________________________________
3. Powers Granted: This Durable Power of Attorney grants the following powers to the Attorney-in-Fact:
- Real Property Transactions
- Tangible Personal Property Transactions
- Stock and Bond Transactions
- Commodity and Option Transactions
- Banking and other Financial Institution Transactions
- Business Operating Transactions
- Insurance and Annuity Transactions
- Estate, Trust, and Other Beneficiary Transactions
- Claims and Litigation
- Personal and Family Maintenance
- Benefits from Social Security, Medicare, Medicaid, or other governmental programs, or military service
- Retirement Plan Transactions
- Tax Matters
4. Durable Power of Attorney: This Power of Attorney shall not be affected by the subsequent disability or incapacity of the Principal.
5. Effective Date: This Power of Attorney becomes effective on the date it is signed by the Principal.
6. Termination: This Power of Attorney will remain in effect until the Principal's death, revocation by the Principal, or until specified otherwise in this Document.
7. Principal Signature:
Date: _______________________________________
Signature: __________________________________
8. Attorney-in-Fact Signature:
Date: _______________________________________
Signature: __________________________________
9. Witnesses: (If required by jurisdiction)
- Name: _________________________________
Signature: _________________________________
- Name: _________________________________
Signature: _________________________________
10. Notarization (If required by jurisdiction)
This Document was acknowledged before me on ________ (date) by ____________________________ (name/s of Principal and/or Attorney-in-Fact).
Name of Notary: ____________________________________
Signature of Notary: _______________________________
Commission Expires: _______________________________