Power Of Attorney Form - Illinois
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3Illinois Power of Attorney
Power of Attorney: made this _______ day of _______ (month) _______ (year)
I, do hereby
[Legal Name], AKA [Name]
A resident of
[City][State]
Located at
[Address]
[City], [State] [Zip Code]
Hereby Appoint:
Name
[Legal Name]
A resident of
[City][State]
Located at
[Address]
[City], [State] [Zip Code]
As my attorney-in-fact otherwise referred to as “agent” to act for me in my name in any way I
could act in person.
If you designate more than one agent above, by default they must act together unless you
initial the statement below.
[___] My agents may act separately.
If every agent that is listed above is unable or unwilling to serve, I hereby appoint as my
successor agent(s):
_____________________________________________________________________________
If you designate more than one successor agent above, by default they must act together
unless you initial the statement below.
[___] My successor agents may act separately.
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