The Illinois Statutory Short Form Power Of Attorney For Property (Page 6 of 8) in pdf

The Illinois Statutory Short Form Power Of Attorney For Property Page 6

State of _________________)

) SS.

County of _______________)

The undersigned, a notary public in and for the above county and state, certifies that

__________________________, known to me to be the same person whose name is subscribed as

principal to the foregoing power of attorney, appeared before me and the witness(es)

____________________________ (and _______________________) in person and acknowledged

signing and delivering the instrument as the free and voluntary act of the principal, for the uses and

purposes therein set forth (, and certified to the correctness of the signature(s) of the agent(s)).

Dated: ___________________

_______________________________

(Notary Public)

My commission expires ___________

(NOTE: You may, but are not required to, request your agent and successor agents to provide specimen

signatures below. If you include specimen signatures in this power of attorney, you must complete the

certification opposite the signatures of the agents.)

Specimen signatures of

I certify that the signatures

agent (and successors)

of my agent (and successors)

are genuine.

___________________________________

_____________________________________

AGENT

PRINCIPAL

___________________________________

_____________________________________

SUCCESSOR AGENT

PRINCIPAL

___________________________________

_____________________________________

SUCCESSOR AGENT

PRINCIPAL

(NOTE: The name, address, and phone number of the person preparing this form or who assisted the

principal in completing this form should be inserted below.)

Maximillienne Elliott, Esq., Principal

The Law Offices of Max Elliott, Ltd.

500 North Michigan Avenue

Suite 300

Chicago, Illinois 60611-3775

312.396.4053

Page 6 of 8: ILLINOIS STATUTORY SHORT FORM POWER OF ATTORNEY - PROPERTY

The Illinois Statutory Short Form Power Of Attorney For Property Page 6