Illinois Power of Attorney for a Child
This document is designed to grant authority to an individual to make decisions on behalf of a minor child in Illinois. This Power of Attorney is in accordance with Illinois law, specifically 755 ILCS 45/2-1.
For the purposes of this document:
- Parent/Guardian Details:
- Name: _________________________
- Address: _______________________
- City, State, Zip Code: __________
- Phone Number: ________________
- Child's Details:
- Name: _________________________
- Date of Birth: _________________
- Address (if different from above): ______________________
- Agent’s Details:
- Name: _________________________
- Address: _______________________
- City, State, Zip Code: __________
- Phone Number: ________________
Scope of Authority:
The Parent/Guardian hereby appoints the Agent to act on behalf of the Child in the following matters:
- Medical Care
- Educational Decisions
- Travel Arrangements
- Other (please specify): ____________________________________
This Power of Attorney becomes effective immediately upon signing and will remain in effect until ____________ (date of expiration or until revoked in writing).
Signatures:
_________________________________________
Parent/Guardian Signature
Date: ______________
_________________________________________
Agent Signature
Date: ______________
Witness:
_________________________________________
Witness Signature
Date: ______________
Notarization:
State of ____________
County of ___________
Subscribed and sworn to before me this _____ day of ____________, 20___.
_________________________________________
Notary Public Signature
My commission expires: _____________