Illinois Durable Power of Attorney
This Illinois Durable Power of Attorney document is designed to grant authority to an agent to make decisions on your behalf regarding financial and healthcare matters. This document is made in accordance with the Illinois Power of Attorney Act (765 ILCS 1003).
Principal Information:
Name: _________________________
Address: _______________________
City, State, Zip: ______________
Date of Birth: __________________
Agent Information:
Name: _________________________
Address: _______________________
City, State, Zip: ______________
Phone Number: _________________
Durability Clause:
This Durable Power of Attorney shall not be affected by my subsequent disability or incapacity. It shall remain in effect until revoked by me in writing.
Effective Date:
This document becomes effective immediately upon signing unless specified otherwise: _______________________ (Date/Condition)
Specific Powers Granted:
- Manage real estate transactions
- Make financial and investment decisions
- Handle tax matters
- Access safe deposit boxes
- Maintain insurance policies
- Make healthcare decisions
Signature of Principal:
__________________________
Date: _____________________
Witnesses:
- Name: ______________________ Signature: ____________________ Date: ________________
- Name: ______________________ Signature: ____________________ Date: ________________
Notary Public:
State of Illinois
County of ____________________
Subscribed and sworn to before me on this __________ day of ____________, 20____.
______________________________
Notary Public Signature
My Commission Expires: ________________