Illinois Limited (Special) Power of Attorney Form

The Illinois limited (special) power of attorney form acts as a written delegation of power, providing an Agent with the ability to perform specific tasks on behalf of an individual (the Principal). This particular form contrasts a general power of attorney form in that it places a scope on the authority granted to the Agent in question, specifying the tasks he/she has the ability to perform. In accordance with State Law, the document must be signed by the Principal in the presence of a witness and a Notary Public (Illinois Power of Attorney Act, 755 ILCS 45).

How to Write

Step 1 – Notice – The Principal must read all of the following Titled Paragraphs as follows:

  • Notice
  • Incapacitation
  • Revocation
  • Witness and Notary

Step 2 – Principal Information –

  • Enter the printed name of the Principal
  • Address
  • City
  • State
  • AND
  • Agent’s printed name
  • Address
  • City
  • State
  • AND
  • Successor Agent’s printed name
  • Address
  • City State
  • AND
  • The Principal must enter a detailed description of the specific powers to be granted to the Agent’s

Step 3 – Titled Paragraphs – The Principal must review the following, prior to application of signatures:

  • Terms and Conditions
  • Third Parties
  • Compensation
  • Disclosure

Step 4 – Signatures – Enter Before a Notary Public:

  • The Principal’s printed name
  • Date of signature in dd/mm format
  • Provide the Principal’s Signature
  • AND A
  • Agent and Successor printed names
  • Agent and Successor Signatures
  • Date the signatures in mm/dd/yyyy
  • AND
  • Witnesses must read the Wittness Attestation Paragraph
  • Witness must Attest to the information on the form by providing their printed names in the same paragraph
  • Enter the Signatures of both witnesses

Step 5 – Notary Acknowledgement –

  • As the notary witnesses the signatures of all parties, they will then acknowledge the document by completing all of the notary’s required information

Step 6 – Acknowledgement and Acceptances of Agent and Successor Agent:

  • Both Agent and Successor, must read the respective paragraphs
  • Enter printed names
  • Enter both signatures
  • Date each signature in mm/dd/yyyy format