Illinois Power of Attorney for a Child
This Power of Attorney for a Child is made in accordance with Illinois state law. It allows the undersigned parent or legal guardian to designate another individual as the child's attorney-in-fact, granting them specific authority regarding the care and well-being of the child.
Principal Information:
- Full Name of Parent/Guardian: _____________________________
- Address: _____________________________________________
- Phone Number: _____________________________________________
Child Information:
- Full Name of Child: _____________________________________________
- Date of Birth: _____________________________________________
- Address: _____________________________________________
Attorney-in-Fact Information:
- Full Name of Attorney-in-Fact: _____________________________________________
- Address: _____________________________________________
- Phone Number: _____________________________________________
Effective Date: This Power of Attorney will be effective from ____________ (date) until ____________ (date) or until it is revoked in writing.
Powers Granted:
The Attorney-in-Fact shall have the authority to perform the following acts on behalf of the child:
- Make decisions regarding the child's education.
- Authorize medical treatment and care.
- Provide consent for the child's participation in activities.
Revocation of Power of Attorney:
The authority granted herein may be revoked at any time by the undersigned parent or guardian upon providing written notice.
Signature:
Signed this ____ day of ____________, 20__.
_________________________________________
(Parent/Guardian Signature)
Witness Information:
Witness 1: _____________________________
Witness 2: _____________________________
Notary Public:
State of Illinois
County of _____________________________
Subscribed and sworn to before me on this ____ day of ____________, 20__.
_________________________________________
Notary Public