Limited Power of Attorney - Illinois

LIMITED POWER OF ATTORNEY — ILLINOIS

Before you use this: Fill in the transaction, authorized acts, property, amount limit, and end time before signing. This is a nonstatutory property power. The principal must sign, have at least one qualified witness observe the signing or acknowledgment, and acknowledge the signature before a notary public. For land, attach its legal description and arrange county recording of this power and any resulting deed or mortgage.

1. Principal and agent

I, [PRINCIPAL FULL LEGAL NAME], of [ADDRESS], appoint [AGENT FULL LEGAL NAME], of [ADDRESS], as my agent solely for the transaction described below.

2. Limited grant

Specific transaction and counterparty: [DESCRIBE]

Acts the agent may perform and documents the agent may sign: [LIST EACH ACT AND DOCUMENT]

Property, account, or asset involved: [IDENTIFY; FOR LAND, ATTACH LEGAL DESCRIPTION]

Maximum payment, receipt, or commitment: $[AMOUNT / NONE]

Additional conditions: [DESCRIBE / NONE]

My agent may communicate with the named counterparty and obtain records only as reasonably needed to perform the listed acts. A blank act or property description grants no authority. This instrument grants no general authority over my other property or affairs. It does not incorporate any category of powers from the Illinois Statutory Short Form Power of Attorney for Property by reference.

3. Powers withheld

My agent may not make gifts; exercise a power of appointment; create or change survivorship rights or beneficiary designations; create, amend, or revoke a trust; delegate discretionary decision-making; transfer my property to the agent for the agent's own benefit; make health-care decisions; execute or change a will; or appear in court as my lawyer. No such power is granted by a general description of the transaction.

4. Effect and end of authority

This power takes effect when I sign it, a qualified witness observes my signing or acknowledgment, and I acknowledge my signature before a notary public. It continues through my later disability or incapacity.

My agent's authority ends upon completion of the stated transaction and, in any event, no later than [DATE AND TIME, INCLUDING TIME ZONE]. It may end sooner upon my death or revocation. This power does not revoke any prior power unless I identify it here: [PRIOR INSTRUMENT TO REVOKE / NONE].

5. Agent's duties

If my agent acts, the agent must act in good faith for my benefit, with due care, competence, and diligence, and within this grant. The agent must keep records of receipts, disbursements, and significant actions taken under this power.

6. Principal's signature

I sign this limited power of attorney voluntarily on [__/__/____] at [CITY, STATE].

Principal's signature: ____________________________________

Printed name: [PRINCIPAL FULL LEGAL NAME]

7. Witness

I witnessed the Principal sign this instrument or acknowledge the Principal's signature in my presence. I am not the agent named here.

☐ I am not a person disqualified from witnessing a property power under 755 ILCS 45/3-3.6(a), including a prohibited health-care provider, facility owner or operator, close family member, agent, or successor agent.

Witness signature: ____________________________________ Date: [__/__/____]

Printed name and address: [NAME AND ADDRESS]

8. Notarial acknowledgment

State of Illinois, County of [COUNTY].

On [__/__/____], [PRINCIPAL FULL LEGAL NAME] personally appeared before me, was identified to my satisfaction, and acknowledged signing this instrument voluntarily.

I am not a person disqualified from notarizing this property power under 755 ILCS 45/3-3.6(a).

Notary public signature: ____________________________________

Printed name: [NAME]

Commission expiration: [DATE] Official seal: [SEAL]

9. Agent's receipt (optional)

I acknowledge receipt of this instrument and agree to act only within its stated limits.

Agent's signature: ____________________________________ Date: [__/__/____]

10. Land-recording instruction

If the listed acts concern title to Illinois land, record this power of attorney and the resulting deed, mortgage, or other title instrument in the county where the land lies under 765 ILCS 5/28. For a land-title instrument executed or acknowledged in Illinois, print the preparer's name and address legibly on the instrument under 55 ILCS 5/3-5022. Confirm the county recorder's submission requirements before presenting the completed instruments.

Prepared by (name and mailing address, if this instrument affects Illinois land title): [NAME AND ADDRESS]