Public Act 096-1195
 
HB6477 EnrolledLRB096 21113 AJO 36964 b

    AN ACT concerning civil law.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The Illinois Power of Attorney Act is amended by
changing Sections 2-1, 2-3, 2-5, 2-7, 2-8, 2-10, 2-11, 3-3,
3-4, 4-4, 4-10, and 4-12 and by adding Sections 2-10.3, 2-10.5,
2-10.6, 3-3.6, 3-5, and 4-5.1 as follows:
 
    (755 ILCS 45/2-1)  (from Ch. 110 1/2, par. 802-1)
    Sec. 2-1. Purpose. The General Assembly recognizes that
each individual has the right to appoint an agent to make deal
with property, financial, or make personal, and health care
decisions for the individual but that this right cannot be
fully effective unless the principal may empower the agent to
act throughout the principal's lifetime, including during
periods of disability, and have confidence be sure that third
parties will honor the agent's authority at all times.
    The General Assembly finds that in the light of modern
financial needs and advances in medical science, the statutory
recognition of this right of delegation in Illinois needs to be
restated, which will to, among other things, expand the its
application and the permissible scope of the agent's authority,
clarify the power of the individual to authorize an agent to
make financial and care decisions for the individual and better
protect health care personnel and other third parties who rely
in good faith on the agent so that reliance will be assured.
Nothing in this Act shall be deemed to authorize or encourage
euthanasia, suicide or any action or course of action that
violates the criminal law of this State or the United States.
Similarly, nothing in this Act shall be deemed to authorize or
encourage any violation of a civil right expressed in the
Constitution, statutes, case law and administrative rulings of
this State (including, without limitation, the right of
conscience respected and protected by the Health Care Right of
Conscience Act, as now or hereafter amended) or the United
States or any action or course of action that violates the
public policy expressed in the Constitution, statutes, case law
and administrative rulings of this State or the United States.
(Source: P.A. 90-655, eff. 7-30-98.)
 
    (755 ILCS 45/2-3)  (from Ch. 110 1/2, par. 802-3)
    Sec. 2-3. Definitions. As used in this Act:
    (a) "Agency" means the written power of attorney or other
instrument of agency governing the relationship between the
principal and agent or the relationship, itself, as appropriate
to the context, and includes agencies dealing with personal or
health care as well as property. An agency is subject to this
Act to the extent it may be controlled by the principal,
excluding agencies and powers for the benefit of the agent.
    (b) "Agent" means the attorney-in-fact or other person
designated to act for the principal in the agency.
    (c) "Disabled person" has the same meaning as in the
"Probate Act of 1975", as now or hereafter amended. To be under
a "disability" or "disabled" means to be a disabled person.
    (c-5) "Incapacitated", when used to describe a principal,
means that the principal is under a legal disability as defined
in Section 11a-2 of the Probate Act of 1975. A principal shall
also be considered incapacitated if: (i) a physician licensed
to practice medicine in all of its branches has examined the
principal and has determined that the principal lacks decision
making capacity; (ii) that physician has made a written record
of this determination and has signed the written record within
90 days after the examination; and (iii) the written record has
been delivered to the agent. The agent may rely conclusively on
the written record.
    (d) "Person" means an individual, corporation, trust,
partnership or other entity, as appropriate to the agency.
    (e) "Principal" means an individual (including, without
limitation, an individual acting as trustee, representative or
other fiduciary) who signs a power of attorney or other
instrument of agency granting powers to an agent.
(Source: P.A. 85-701.)
 
    (755 ILCS 45/2-5)  (from Ch. 110 1/2, par. 802-5)
    Sec. 2-5. Duration of agency - amendment and revocation.
Unless the agency states an earlier termination date, the
agency continues until the death of the principal,
notwithstanding any lapse of time, the principal's disability
or incapacity or appointment of a guardian for the principal
after the agency is signed. Every agency may be amended or
revoked by the principal, if the principal has the capacity to
do so, at any time and in any manner communicated to the agent
or to any other person related to the subject matter of the
agency, except that revocation and amendment of health care
agencies are governed by Section 4-6 of this Act except to the
extent the terms of the agencies are inconsistent with that
Section. The execution of a power of attorney does not revoke a
power of attorney previously executed by the principal unless
the subsequent power of attorney provides that the previous
power of attorney is revoked or that all other powers of
attorney are revoked.
(Source: P.A. 86-736.)
 
    (755 ILCS 45/2-7)  (from Ch. 110 1/2, par. 802-7)
    Sec. 2-7. Duty - standard of care - record-keeping -
exoneration.
    (a) The agent shall be under no duty to exercise the powers
granted by the agency or to assume control of or responsibility
for any of the principal's property, care or affairs,
regardless of the principal's physical or mental condition.
Whenever a power is exercised, the agent shall use due care to
act in good faith for the benefit of the principal using due
care, competence, and diligence in accordance with the terms of
the agency and shall be liable for negligent exercise. An agent
who acts with due care for the benefit of the principal shall
not be liable or limited merely because the agent also benefits
from the act, has individual or conflicting interests in
relation to the property, care or affairs of the principal or
acts in a different manner with respect to the agency and the
agent's individual interests. The agent shall keep a record of
all receipts, disbursements, and significant actions taken
under the agency. The agent shall not be affected by any
amendment or termination of the agency until the agent has
actual knowledge thereof. The agent shall not be liable for any
loss due to error of judgment nor for the act or default of any
other person.
    (b) An agent that has accepted appointment must act in
accordance with the principal's expectations to the extent
actually known to the agent and otherwise in the principal's
best interests.
    (c) An agent shall keep a record of all receipts,
disbursements, and significant actions taken under the
authority of the agency and shall provide a copy of this record
when requested to do so by:
        (1) the principal, a guardian, another fiduciary
    acting on behalf of the principal, and, after the death of
    the principal, the personal representative or successors
    in interest of the principal's estate;
        (2) a representative of a provider agency, as defined
    in Section 2 of the Elder Abuse and Neglect Act, acting in
    the course of an assessment of a complaint of elder abuse
    or neglect under that Act;
        (3) a representative of the Office of the State Long
    Term Care Ombudsman, acting in the course of an
    investigation of a complaint of financial exploitation of a
    nursing home resident under Section 4.04 of the Illinois
    Act on the Aging;
        (4) a representative of the Office of Inspector General
    for the Department of Human Services, acting in the course
    of an assessment of a complaint of financial exploitation
    of an adult with disabilities pursuant to Section 35 of the
    Abuse of Adults with Disabilities Intervention Act; or
        (5) a court under Section 2-10 of this Act.
    (d) If the agent fails to provide his or her record of all
receipts, disbursements, and significant actions within 21
days after a request under subsection (c), the elder abuse
provider agency or the State Long Term Care Ombudsman may
petition the court for an order requiring the agent to produce
his or her record of receipts, disbursements, and significant
actions. If the court finds that the agent's failure to provide
his or her record in a timely manner to the elder abuse
provider agency or the State Long Term Care Ombudsman was
without good cause, the court may assess reasonable costs and
attorney's fees against the agent, and order such other relief
as is appropriate.
    (e) An agent is not required to disclose receipts,
disbursements, or other significant actions conducted on
behalf of the principal except as otherwise provided in the
power of attorney or as required under subsection (c).
    (f) An agent that violates this Act is liable to the
principal or the principal's successors in interest for the
amount required (i) to restore the value of the principal's
property to what it would have been had the violation not
occurred, and (ii) to reimburse the principal or the
principal's successors in interest for the attorney's fees and
costs paid on the agent's behalf. This subsection does not
limit any other applicable legal or equitable remedies.
(Source: P.A. 86-736.)
 
    (755 ILCS 45/2-8)  (from Ch. 110 1/2, par. 802-8)
    Sec. 2-8. Reliance on document purporting to establish an
agency.
    (a) Any person who acts in good faith reliance on a copy of
a document purporting to establish an agency will be fully
protected and released to the same extent as though the reliant
had dealt directly with the named principal as a
fully-competent person. The named agent shall furnish an
affidavit or Agent's Certification and Acceptance of Authority
to the reliant on demand stating that the instrument relied on
is a true copy of the agency and that, to the best of the named
agent's knowledge, the named principal is alive and the
relevant powers of the named agent have not been altered or
terminated; but good faith reliance on a document purporting to
establish an agency will protect the reliant without the
affidavit or Agent's Certification and Acceptance of
Authority.
    (b) Upon request, the named agent in a power of attorney
shall furnish an Agent's Certification and Acceptance of
Authority to the reliant in substantially the following form:
 
AGENT'S CERTIFICATION AND ACCEPTANCE OF AUTHORITY

 
    I, .......... (insert name of agent), certify that the
attached is a true copy of a power of attorney naming the
undersigned as agent or successor agent for .............
(insert name of principal).
    I certify that to the best of my knowledge the principal
had the capacity to execute the power of attorney, is alive,
and has not revoked the power of attorney; that my powers as
agent have not been altered or terminated; and that the power
of attorney remains in full force and effect.
    I accept appointment as agent under this power of attorney.
    This certification and acceptance is made under penalty of
perjury.*
    Dated: ............
.......................
(Agent's Signature)
.......................
(Print Agent's Name)
.......................
(Agent's Address)
    *(NOTE: Perjury is defined in Section 32-2 of the Criminal
Code of 1961, and is a Class 3 felony.)
 
    (c) Any person dealing with an agent named in a copy of a
document purporting to establish an agency may presume, in the
absence of actual knowledge to the contrary, that the document
purporting to establish the agency was validly executed, that
the agency was validly established, that the named principal
was competent at the time of execution, and that, at the time
of reliance, the named principal is alive, the agency was
validly established and has not terminated or been amended, the
relevant powers of the named agent were properly and validly
granted and have not terminated or been amended, and the acts
of the named agent conform to the standards of this Act. No
person relying on a copy of a document purporting to establish
an agency shall be required to see to the application of any
property delivered to or controlled by the named agent or to
question the authority of the named agent.
    (d) Each person to whom a direction by the named agent in
accordance with the terms of the copy of the document
purporting to establish an agency is communicated shall comply
with that direction, and any person who fails to comply
arbitrarily or without reasonable cause shall be subject to
civil liability for any damages resulting from noncompliance. A
health care provider who complies with Section 4-7 shall not be
deemed to have acted arbitrarily or without reasonable cause.
(Source: P.A. 90-21, eff. 6-20-97.)
 
    (755 ILCS 45/2-10)  (from Ch. 110 1/2, par. 802-10)
    Sec. 2-10. Agency-court relationship.
    (a) Upon petition by any interested person (including the
agent), with such notice to interested persons as the court
directs and a finding by the court that the principal lacks
either the capacity to control or the capacity to revoke the
agency, the court may construe a power of attorney, review the
agent's conduct, and grant appropriate relief including
compensatory damages. : (a) if
    (b) If the court finds that the agent is not acting for the
benefit of the principal in accordance with the terms of the
agency or that the agent's action or inaction has caused or
threatens substantial harm to the principal's person or
property in a manner not authorized or intended by the
principal, the court may order a guardian of the principal's
person or estate to exercise any powers of the principal under
the agency, including the power to revoke the agency, or may
enter such other orders without appointment of a guardian as
the court deems necessary to provide for the best interests of
the principal.
    (c) If ; or (b) if the court finds that the agency requires
interpretation, the court may construe the agency and instruct
the agent, but the court may not amend the agency.
    (d) If the court finds that the agent has not acted for the
benefit of the principal in accordance with the terms of the
agency and the Illinois Power of Attorney Act, or that the
agent's action caused or threatened substantial harm to the
principal's person or property in a manner not authorized or
intended by the principal, then the agent shall not be
authorized to pay or be reimbursed from the estate of the
principal the attorneys' fees and costs of the agent in
defending a proceeding brought pursuant to this Section.
    (e) Upon a finding that the agent's action has caused
substantial harm to the principal's person or property, the
court may assess against the agent reasonable costs and
attorney's fees to a prevailing party who is a provider agency
as defined in Section 2 of the Elder Abuse and Neglect Act, a
representative of the Office of the State Long Term Care
Ombudsman, or a governmental agency having regulatory
authority to protect the welfare of the principal.
    (f) As used in this Section, the term "interested person"
includes (1) the principal or the agent; (2) a guardian of the
person, guardian of the estate, or other fiduciary charged with
management of the principal's property; (3) the principal's
spouse, parent, or descendant; (4) a person who would be a
presumptive heir-at-law of the principal; (5) a person named as
a beneficiary to receive any property, benefit, or contractual
right upon the principal's death, or as a beneficiary of a
trust created by or for the principal; (6) a provider agency as
defined in Section 2 of the Elder Abuse and Neglect Act, a
representative of the Office of the State Long Term Care
Ombudsman, or a governmental agency having regulatory
authority to protect the welfare of the principal; and (7) the
principal's caregiver or another person who demonstrates
sufficient interest in the principal's welfare.
    (g) Absent court order directing a guardian to exercise
powers of the principal under the agency, a guardian will have
no power, duty or liability with respect to any property
subject to the agency or any personal or health care matters
covered by the agency.
    (h) Proceedings under this Section shall be commenced in
the county where the guardian was appointed or, if no Illinois
guardian is acting, then in the county where the agent or
principal resides or where the principal owns real property or,
if the agent does not reside in Illinois, then in any county.
    (i) This Section shall not be construed to limit any other
remedies available.
(Source: P.A. 85-701.)
 
    (755 ILCS 45/2-10.3 new)
    Sec. 2-10.3. Successor agents.
    (a) A principal may designate one or more successor agents
to act if an initial or predecessor agent resigns, dies,
becomes incapacitated, is not qualified to serve, or declines
to serve. A principal may grant authority to another person,
designated by name, by office, or by function, including an
initial or successor agent, to designate one or more successor
agents. Unless a power of attorney otherwise provides, a
successor agent has the same authority as that granted to an
initial agent.
    (b) An agent is not liable for the actions of another
agent, including a predecessor agent, unless the agent
participates in or conceals a breach of fiduciary duty
committed by the other agent. An agent who has knowledge of a
breach or imminent breach of fiduciary duty by another agent
must notify the principal and, if the principal is
incapacitated, take whatever actions may be reasonably
appropriate in the circumstances to safeguard the principal's
best interest.
    (c) Any person who acts in good faith reliance on the
representation of a successor agent regarding the
unavailability of a predecessor agent will be fully protected
and released to the same extent as though the reliant had dealt
directly with the predecessor agent. Upon request, the
successor agent shall furnish an affidavit or Successor Agent's
Certification and Acceptance of Authority to the reliant, but
good faith reliance on a document purporting to establish an
agency will protect the reliant without the affidavit or
Successor Agent's Certification and Acceptance of Authority. A
Successor Agent's Certification and Acceptance of Authority
shall be in substantially the following form:
 
SUCCESSOR AGENT'S
CERTIFICATION AND ACCEPTANCE OF AUTHORITY

 
    I certify that the attached is a true copy of a power of
attorney naming the undersigned as agent or successor agent for
.......... (insert name of principal).
    I certify that to the best of my knowledge the principal
had the capacity to execute the power of attorney, is alive,
and has not revoked the power of attorney; that my powers as
agent have not been altered or terminated; and that the power
of attorney remains in full force and effect.
    I certify that to the best of my knowledge ..........
(insert name of unavailable agent) is unavailable due to
................. (specify death, resignation, absence,
illness, or other temporary incapacity).
    I accept appointment as agent under this power of attorney.
    This certification and acceptance is made under penalty of
perjury.*
    Dated: ............
.......................
(Agent's Signature)
.......................
(Print Agent's Name)
.......................
(Agent's Address)
    *(NOTE: Perjury is defined in Section 32-2 of the Criminal
Code of 1961, and is a Class 3 felony.)
 
    (755 ILCS 45/2-10.5 new)
    Sec. 2-10.5. Co-agents.
    (a) Co-agents may not be named by a principal in a
statutory short form power of attorney for property under
Article III or a statutory short form power of attorney for
health care under Article IV. In the event that co-agents are
named in any other form of power of attorney, then the
provisions of this Section shall govern the use and acceptance
of co-agency designations.
    (b) Unless the power of attorney or this Section otherwise
provides, authority granted to 2 or more co-agents is
exercisable only by their majority consent. However, if prompt
action is required to accomplish the purposes of the power of
attorney or to avoid irreparable injury to the principal's
interests and an agent is unavailable because of absence,
illness, or other temporary incapacity, the other agent or
agents may act for the principal. If a vacancy occurs in one or
more of the designations of agent under a power of attorney,
the remaining agent or agents may act for the principal.
    (c) An agent is not liable for the actions of another
agent, including a co-agent or predecessor agent, unless the
agent participates in or conceals a breach of fiduciary duty
committed by the other agent. An agent who has knowledge of a
breach or imminent breach of fiduciary duty by another agent
must notify the principal and, if the principal is
incapacitated, take whatever actions may be reasonably
appropriate in the circumstances to safeguard the principal's
best interest.
    (d) Any person who acts in good faith reliance on the
representation of a co-agent regarding the unavailability of a
predecessor agent or one or more co-agents, or the need for
prompt action to accomplish the purposes of the power of
attorney or to avoid irreparable injury to the principal's
interests, will be fully protected and released to the same
extent as though the reliant had dealt directly with all named
agents. Upon request, the co-agent shall furnish an affidavit
or Co-Agent's Certification and Acceptance of Authority to the
reliant, but good faith reliance on a document purporting to
establish an agency will protect the reliant without the
affidavit or Co-Agent's Certification and Acceptance of
Authority. A Co-Agent's Certification and Acceptance of
Authority shall be in substantially the following form:
 
CO-AGENT'S
CERTIFICATION AND ACCEPTANCE OF AUTHORITY

 
    I certify that the attached is a true copy of a power of
attorney naming the undersigned as agent or co-agent for
.......... (insert name of principal).
    I certify that to the best of my knowledge the principal
had the capacity to execute the power of attorney, is alive,
and has not revoked the power of attorney; that my powers as
agent have not been altered or terminated; and that the power
of attorney remains in full force and effect.
    I certify that to the best of my knowledge ..........
(insert name of unavailable agent) is unavailable due to
................. (specify death, resignation, absence,
illness, or other temporary incapacity).
    I certify that prompt action is required to accomplish the
purposes of the power of attorney or to avoid irreparable
injury to the principal's interests.
    I accept appointment as agent under this power of attorney.
    This certification and acceptance is made under penalty of
perjury.*
    Dated: ............
.......................
(Agent's Signature)
.......................
(Print Agent's Name)
.......................
(Agent's Address)
    *(NOTE: Perjury is defined in Section 32-2 of the Criminal
Code of 1961, and is a Class 3 felony.)
 
    (755 ILCS 45/2-10.6 new)
    Sec. 2-10.6. Power of attorney executed in another state or
country; pre-existing powers of attorney.
    (a) A power of attorney executed in another state or
country is valid and enforceable in this State if its creation
complied when executed with:
        (1) the law of the state or country in which the power
    of attorney was executed;
        (2) the law of this State;
        (3) the law of the state or country where the principal
    is domiciled, has a place of abode or business, or is a
    national; or
        (4) the law of the state or country where the agent is
    domiciled or has a place of business.
    (b) A power of attorney executed in this State before the
effective date of this amendatory Act of the 96th General
Assembly is valid and enforceable in this State if its creation
complied with the law of this State as it existed at the time
of execution.
 
    (755 ILCS 45/2-11)  (from Ch. 110 1/2, par. 802-11)
    Sec. 2-11. Saving clause. This Act does not in any way
invalidate any agency executed or any act of any agent done, or
affect any claim, right or remedy that accrued, prior to
September 22, 1987.
    This amendatory Act of the 96th General Assembly does not
in any way invalidate any agency executed or any act of any
agent done, or affect any claim, right, or remedy that accrued
prior to the effective date of this amendatory Act of the 96th
General Assembly.
(Source: P.A. 86-736.)
 
    (755 ILCS 45/3-3)  (from Ch. 110 1/2, par. 803-3)
    Sec. 3-3. Statutory short form power of attorney for
property.
    (a) The following form prescribed in this Section may be
known as "statutory property power" and may be used to grant an
agent powers with respect to property and financial matters.
The "statutory property power" consists of the following: (1)
Notice to the Individual Signing the Illinois Statutory Short
Form Power of Attorney for Property; (2) Illinois Statutory
Short Form Power of Attorney for Property; and (3) Notice to
Agent. When a power of attorney in substantially the following
form prescribed in this Section is used, including all 3 items
above, with item (1), the Notice to Individual Signing the
Illinois Statutory Short Form Power of Attorney for Property,
on a separate sheet (coversheet) in 14-point type the "notice"
paragraph at the beginning in capital letters and the notarized
form of acknowledgment at the end, it shall have the meaning
and effect prescribed in this Act.
    (b) A power of attorney shall also be deemed to be in
substantially the same format as the statutory form if the
explanatory language throughout the form (the language
following the designation "NOTE:") is distinguished in some way
from the legal paragraphs in the form, such as the use of
boldface or other difference in typeface and font or point
size, even if the "Notice" paragraphs at the beginning are not
on a separate sheet of paper or are not in 14-point type, or if
the principal's initials do not appear in the acknowledgement
at the end of the "Notice" paragraphs.
    The validity of a power of attorney as meeting the
requirements of a statutory property power shall not be
affected by the fact that one or more of the categories of
optional powers listed in the form are struck out or the form
includes specific limitations on or additions to the agent's
powers, as permitted by the form. Nothing in this Article shall
invalidate or bar use by the principal of any other or
different form of power of attorney for property. Nonstatutory
property powers (i) must be executed by the principal, (ii)
must and designate the agent and the agent's powers, (iii) must
be signed by at least one witness to the principal's signature,
and (iv) must indicate that the principal has acknowledged his
or her signature before a notary public. However, nonstatutory
property powers , but they need not be acknowledged or conform
in any other respect to the statutory property power.
    (c) The Notice to the Individual Signing the Illinois
Statutory Short Form Power of Attorney for Property shall be
substantially as follows:
 
"NOTICE TO THE INDIVIDUAL SIGNING THE ILLINOIS
STATUTORY SHORT FORM POWER OF ATTORNEY FOR PROPERTY.

 
    PLEASE READ THIS NOTICE CAREFULLY. The form that you will
be signing is a legal document. It is governed by the Illinois
Power of Attorney Act. If there is anything about this form
that you do not understand, you should ask a lawyer to explain
it to you.
    The purpose of this Power of Attorney is to give your
designated "agent" broad powers to handle your financial
affairs, which may include the power to pledge, sell, or
dispose of any of your real or personal property, even without
your consent or any advance notice to you. When using the
Statutory Short Form, you may name successor agents, but you
may not name co-agents.
    This form does not impose a duty upon your agent to handle
your financial affairs, so it is important that you select an
agent who will agree to do this for you. It is also important
to select an agent whom you trust, since you are giving that
agent control over your financial assets and property. Any
agent who does act for you has a duty to act in good faith for
your benefit and to use due care, competence, and diligence. He
or she must also act in accordance with the law and with the
directions in this form. Your agent must keep a record of all
receipts, disbursements, and significant actions taken as your
agent.
    Unless you specifically limit the period of time that this
Power of Attorney will be in effect, your agent may exercise
the powers given to him or her throughout your lifetime, both
before and after you become incapacitated. A court, however,
can take away the powers of your agent if it finds that the
agent is not acting properly. You may also revoke this Power of
Attorney if you wish.
    This Power of Attorney does not authorize your agent to
appear in court for you as an attorney-at-law or otherwise to
engage in the practice of law unless he or she is a licensed
attorney who is authorized to practice law in Illinois.
    The powers you give your agent are explained more fully in
Section 3-4 of the Illinois Power of Attorney Act. This form is
a part of that law. The "NOTE" paragraphs throughout this form
are instructions.
    You are not required to sign this Power of Attorney, but it
will not take effect without your signature. You should not
sign this Power of Attorney if you do not understand everything
in it, and what your agent will be able to do if you do sign it.
 
    Please place your initials on the following line indicating
that you have read this Notice:
.....................
Principal's initials"

 
    (d) The Illinois Statutory Short Form Power of Attorney for
Property shall be substantially as follows:
 
"ILLINOIS STATUTORY SHORT FORM
POWER OF ATTORNEY FOR PROPERTY

 
    (NOTICE: THE PURPOSE OF THIS POWER OF ATTORNEY IS TO GIVE
THE PERSON YOU DESIGNATE (YOUR "AGENT") BROAD POWERS TO HANDLE
YOUR PROPERTY, WHICH MAY INCLUDE POWERS TO PLEDGE, SELL OR
OTHERWISE DISPOSE OF ANY REAL OR PERSONAL PROPERTY WITHOUT
ADVANCE NOTICE TO YOU OR APPROVAL BY YOU. THIS FORM DOES NOT
IMPOSE A DUTY ON YOUR AGENT TO EXERCISE GRANTED POWERS; BUT
WHEN POWERS ARE EXERCISED, YOUR AGENT WILL HAVE TO USE DUE CARE
TO ACT FOR YOUR BENEFIT AND IN ACCORDANCE WITH THIS FORM AND
KEEP A RECORD OF RECEIPTS, DISBURSEMENTS AND SIGNIFICANT
ACTIONS TAKEN AS AGENT. A COURT CAN TAKE AWAY THE POWERS OF
YOUR AGENT IF IT FINDS THE AGENT IS NOT ACTING PROPERLY. YOU
MAY NAME SUCCESSOR AGENTS UNDER THIS FORM BUT NOT CO-AGENTS.
UNLESS YOU EXPRESSLY LIMIT THE DURATION OF THIS POWER IN THE
MANNER PROVIDED BELOW, UNTIL YOU REVOKE THIS POWER OR A COURT
ACTING ON YOUR BEHALF TERMINATES IT, YOUR AGENT MAY EXERCISE
THE POWERS GIVEN HERE THROUGHOUT YOUR LIFETIME, EVEN AFTER YOU
BECOME DISABLED. THE POWERS YOU GIVE YOUR AGENT ARE EXPLAINED
MORE FULLY IN SECTION 3-4 OF THE ILLINOIS "STATUTORY SHORT FORM
POWER OF ATTORNEY FOR PROPERTY LAW" OF WHICH THIS FORM IS A
PART (SEE THE BACK OF THIS FORM). THAT LAW EXPRESSLY PERMITS
THE USE OF ANY DIFFERENT FORM OF POWER OF ATTORNEY YOU MAY
DESIRE. IF THERE IS ANYTHING ABOUT THIS FORM THAT YOU DO NOT
UNDERSTAND, YOU SHOULD ASK A LAWYER TO EXPLAIN IT TO YOU.)
    POWER OF ATTORNEY made this .... day of ....... (month)
...... (year)
    1. I, ..............., (insert name and address of
principal) hereby revoke all prior powers of attorney for
property executed by me and appoint:
.............................................................
                  (insert name and address of agent)
    (NOTE: You may not name co-agents using this form.)
as my attorney-in-fact (my "agent") to act for me and in my
name (in any way I could act in person) with respect to the
following powers, as defined in Section 3-4 of the "Statutory
Short Form Power of Attorney for Property Law" (including all
amendments), but subject to any limitations on or additions to
the specified powers inserted in paragraph 2 or 3 below:
 
(NOTE: You must strike out any one or more of the following
categories of powers you do not want your agent to have.
Failure to strike the title of any category will cause the
powers described in that category to be granted to the agent.
To strike out a category you must draw a line through the title
of that category.) (YOU MUST STRIKE OUT ANY ONE OR MORE OF THE
FOLLOWING CATEGORIES OF POWERS YOU DO NOT WANT YOUR AGENT TO
HAVE. FAILURE TO STRIKE THE TITLE OF ANY CATEGORY WILL CAUSE
THE POWERS DESCRIBED IN THAT CATEGORY TO BE GRANTED TO THE
AGENT. TO STRIKE OUT A CATEGORY YOU MUST DRAW A LINE THROUGH
THE TITLE OF THAT CATEGORY.)
    (a) Real estate transactions.
    (b) Financial institution transactions.
    (c) Stock and bond transactions.
    (d) Tangible personal property transactions.
    (e) Safe deposit box transactions.
    (f) Insurance and annuity transactions.
    (g) Retirement plan transactions.
    (h) Social Security, employment and military service
benefits.
    (i) Tax matters.
    (j) Claims and litigation.
    (k) Commodity and option transactions.
    (l) Business operations.
    (m) Borrowing transactions.
    (n) Estate transactions.
    (o) All other property powers and transactions.
(NOTE: Limitations on and additions to the agent's powers may
be included in this power of attorney if they are specifically
described below.) (LIMITATIONS ON AND ADDITIONS TO THE AGENT'S
POWERS MAY BE INCLUDED IN THIS POWER OF ATTORNEY IF THEY ARE
SPECIFICALLY DESCRIBED BELOW.)
    2. The powers granted above shall not include the following
powers or shall be modified or limited in the following
particulars:
(NOTE: Here here you may include any specific limitations you
deem appropriate, such as a prohibition or conditions on the
sale of particular stock or real estate or special rules on
borrowing by the agent.):
.............................................................
.............................................................
.............................................................
.............................................................
.............................................................
    3. In addition to the powers granted above, I grant my
agent the following powers:
(NOTE: Here here you may add any other delegable powers
including, without limitation, power to make gifts, exercise
powers of appointment, name or change beneficiaries or joint
tenants or revoke or amend any trust specifically referred to
below.):
.............................................................
.............................................................
.............................................................
.............................................................
.............................................................
(NOTE: Your agent will have authority to employ other persons
as necessary to enable the agent to properly exercise the
powers granted in this form, but your agent will have to make
all discretionary decisions. If you want to give your agent the
right to delegate discretionary decision-making powers to
others, you should keep paragraph 4, otherwise it should be
struck out.) (YOUR AGENT WILL HAVE AUTHORITY TO EMPLOY OTHER
PERSONS AS NECESSARY TO ENABLE THE AGENT TO PROPERLY EXERCISE
THE POWERS GRANTED IN THIS FORM, BUT YOUR AGENT WILL HAVE TO
MAKE ALL DISCRETIONARY DECISIONS. IF YOU WANT TO GIVE YOUR
AGENT THE RIGHT TO DELEGATE DISCRETIONARY DECISION-MAKING
POWERS TO OTHERS, YOU SHOULD KEEP THE NEXT SENTENCE, OTHERWISE
IT SHOULD BE STRUCK OUT.)
    4. My agent shall have the right by written instrument to
delegate any or all of the foregoing powers involving
discretionary decision-making to any person or persons whom my
agent may select, but such delegation may be amended or revoked
by any agent (including any successor) named by me who is
acting under this power of attorney at the time of reference.
(NOTE: Your agent will be entitled to reimbursement for all
reasonable expenses incurred in acting under this power of
attorney. Strike out paragraph 5 if you do not want your agent
to also be entitled to reasonable compensation for services as
agent.) (YOUR AGENT WILL BE ENTITLED TO REIMBURSEMENT FOR ALL
REASONABLE EXPENSES INCURRED IN ACTING UNDER THIS POWER OF
ATTORNEY. STRIKE OUT THE NEXT SENTENCE IF YOU DO NOT WANT YOUR
AGENT TO ALSO BE ENTITLED TO REASONABLE COMPENSATION FOR
SERVICES AS AGENT.)
    5. My agent shall be entitled to reasonable compensation
for services rendered as agent under this power of attorney.
(NOTE: This power of attorney may be amended or revoked by you
at any time and in any manner. Absent amendment or revocation,
the authority granted in this power of attorney will become
effective at the time this power is signed and will continue
until your death, unless a limitation on the beginning date or
duration is made by initialing and completing one or both of
paragraphs 6 and 7:) (THIS POWER OF ATTORNEY MAY BE AMENDED OR
REVOKED BY YOU AT ANY TIME AND IN ANY MANNER. ABSENT AMENDMENT
OR REVOCATION, THE AUTHORITY GRANTED IN THIS POWER OF ATTORNEY
WILL BECOME EFFECTIVE AT THE TIME THIS POWER IS SIGNED AND WILL
CONTINUE UNTIL YOUR DEATH UNLESS A LIMITATION ON THE BEGINNING
DATE OR DURATION IS MADE BY INITIALING AND COMPLETING EITHER
(OR BOTH) OF THE FOLLOWING:)
    6. ( ) This power of attorney shall become effective on
.............................................................
(NOTE: Insert insert a future date or event during your
lifetime, such as a court determination of your disability or a
written determination by your physician that you are
incapacitated, when you want this power to first take effect.)
    7. ( ) This power of attorney shall terminate on
.............................................................
(NOTE: Insert insert a future date or event, such as a court
determination that you are not under a legal disability or a
written determination by your physician that you are not
incapacitated, if of your disability, when you want this power
to terminate prior to your death.)
(NOTE: If you wish to name one or more successor agents, insert
the name and address of each successor agent in paragraph 8.)
(IF YOU WISH TO NAME SUCCESSOR AGENTS, INSERT THE NAME(S) AND
ADDRESS(ES) OF SUCH SUCCESSOR(S) IN THE FOLLOWING PARAGRAPH.)
    8. If any agent named by me shall die, become incompetent,
resign or refuse to accept the office of agent, I name the
following (each to act alone and successively, in the order
named) as successor(s) to such agent:
.............................................................
.............................................................
For purposes of this paragraph 8, a person shall be considered
to be incompetent if and while the person is a minor or an
adjudicated incompetent or disabled person or the person is
unable to give prompt and intelligent consideration to business
matters, as certified by a licensed physician.
(NOTE: If you wish to, you may name your agent as guardian of
your estate if a court decides that one should be appointed. To
do this, retain paragraph 9, and the court will appoint your
agent if the court finds that this appointment will serve your
best interests and welfare. Strike out paragraph 9 if you do
not want your agent to act as guardian.) (IF YOU WISH TO NAME
YOUR AGENT AS GUARDIAN OF YOUR ESTATE, IN THE EVENT A COURT
DECIDES THAT ONE SHOULD BE APPOINTED, YOU MAY, BUT ARE NOT
REQUIRED TO, DO SO BY RETAINING THE FOLLOWING PARAGRAPH. THE
COURT WILL APPOINT YOUR AGENT IF THE COURT FINDS THAT SUCH
APPOINTMENT WILL SERVE YOUR BEST INTERESTS AND WELFARE. STRIKE
OUT PARAGRAPH 9 IF YOU DO NOT WANT YOUR AGENT TO ACT AS
GUARDIAN.)
    9. If a guardian of my estate (my property) is to be
appointed, I nominate the agent acting under this power of
attorney as such guardian, to serve without bond or security.
    10. I am fully informed as to all the contents of this form
and understand the full import of this grant of powers to my
agent.
(NOTE: This form does not authorize your agent to appear in
court for you as an attorney-at-law or otherwise to engage in
the practice of law unless he or she is a licensed attorney who
is authorized to practice law in Illinois.)
    11. The Notice to Agent is incorporated by reference and
included as part of this form.
Dated: ................
            Signed ..........................................
(principal)
    (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 correct.
..........................     .............................
         (agent)                       (principal)
..........................     .............................
    (successor agent)                  (principal)
..........................     .............................
    (successor agent)                  (principal)
 
(NOTE: This power of attorney will not be effective unless it
is signed by at least one witness and your signature is
notarized, using the form below. The notary may not also sign
as a witness.) (THIS POWER OF ATTORNEY WILL NOT BE EFFECTIVE
UNLESS IT IS NOTARIZED AND SIGNED BY AT LEAST ONE ADDITIONAL
WITNESS, USING THE FORM BELOW.)
 
The undersigned witness 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 notary public and acknowledged signing and
delivering the instrument as the free and voluntary act of the
principal, for the uses and purposes therein set forth. I
believe him or her to be of sound mind and memory. The
undersigned witness also certifies that the witness is not: (a)
the attending physician or mental health service provider or a
relative of the physician or provider; (b) an owner, operator,
or relative of an owner or operator of a health care facility
in which the principal is a patient or resident; (c) a parent,
sibling, descendant, or any spouse of such parent, sibling, or
descendant of either the principal or any agent or successor
agent under the foregoing power of attorney, whether such
relationship is by blood, marriage, or adoption; or (d) an
agent or successor agent under the foregoing power of attorney.
Dated: ................
..............................
Witness

 
(NOTE: Illinois requires only one witness, but other
jurisdictions may require more than one witness. If you wish to
have a second witness, have him or her certify and sign here:)
 
(Second witness) The undersigned witness 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 notary public and acknowledged
signing and delivering the instrument as the free and voluntary
act of the principal, for the uses and purposes therein set
forth. I believe him or her to be of sound mind and memory. The
undersigned witness also certifies that the witness is not: (a)
the attending physician or mental health service provider or a
relative of the physician or provider; (b) an owner, operator,
or relative of an owner or operator of a health care facility
in which the principal is a patient or resident; (c) a parent,
sibling, descendant, or any spouse of such parent, sibling, or
descendant of either the principal or any agent or successor
agent under the foregoing power of attorney, whether such
relationship is by blood, marriage, or adoption; or (d) an
agent or successor agent under the foregoing power of attorney.
Dated: .......................
..............................
Witness

 
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 ..............)
additional witness 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: ................ (SEAL)
..............................
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)
 
The undersigned witness 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 notary public and acknowledged signing and
delivering the instrument as the free and voluntary act of the
principal, for the uses and purposes therein set forth. I
believe him or her to be of sound mind and memory.
Dated: ................ (SEAL)
..............................
Witness
(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.) (THE NAME AND ADDRESS OF
THE PERSON PREPARING THIS FORM SHOULD BE INSERTED IF THE AGENT
WILL HAVE POWER TO CONVEY ANY INTEREST IN REAL ESTATE.)
Name:  ....................... 
Address:  .................... 
.............................. 
.............................. 
Phone: .................... 
 
This document was prepared by:
.............................................................
............................................................."
 
    (e) Notice to Agent. The following form may be known as
"Notice to Agent" and shall be supplied to an agent appointed
under a power of attorney for property.
 
"NOTICE TO AGENT
    When you accept the authority granted under this power of
attorney a special legal relationship, known as agency, is
created between you and the principal. Agency imposes upon you
duties that continue until you resign or the power of attorney
is terminated or revoked.
    As agent you must:
        (1) do what you know the principal reasonably expects
    you to do with the principal's property;
        (2) act in good faith for the best interest of the
    principal, using due care, competence, and diligence;
        (3) keep a complete and detailed record of all
    receipts, disbursements, and significant actions conducted
    for the principal;
        (4) attempt to preserve the principal's estate plan, to
    the extent actually known by the agent, if preserving the
    plan is consistent with the principal's best interest; and
        (5) cooperate with a person who has authority to make
    health care decisions for the principal to carry out the
    principal's reasonable expectations to the extent actually
    in the principal's best interest.
    As agent you must not do any of the following:
        (1) act so as to create a conflict of interest that is
    inconsistent with the other principles in this Notice to
    Agent;
        (2) do any act beyond the authority granted in this
    power of attorney;
        (3) commingle the principal's funds with your funds;
        (4) borrow funds or other property from the principal,
    unless otherwise authorized;
        (5) continue acting on behalf of the principal if you
    learn of any event that terminates this power of attorney
    or your authority under this power of attorney, such as the
    death of the principal, your legal separation from the
    principal, or the dissolution of your marriage to the
    principal.
    If you have special skills or expertise, you must use those
special skills and expertise when acting for the principal. You
must disclose your identity as an agent whenever you act for
the principal by writing or printing the name of the principal
and signing your own name "as Agent" in the following manner:
    "(Principal's Name) by (Your Name) as Agent"
    The meaning of the powers granted to you is contained in
Section 3-4 of the Illinois Power of Attorney Act, which is
incorporated by reference into the body of the power of
attorney for property document.
    If you violate your duties as agent or act outside the
authority granted to you, you may be liable for any damages,
including attorney's fees and costs, caused by your violation.
    If there is anything about this document or your duties
that you do not understand, you should seek legal advice from
an attorney."
 
    (f) The requirement of the signature of a witness in
addition to the principal and the notary, an additional witness
imposed by Public Act 91-790, this amendatory Act of the 91st
General Assembly applies only to instruments executed on or
after June 9, 2000 (the effective date of that Public Act).
this amendatory Act of the 91st General Assembly.
(NOTE: This amendatory Act of the 96th General Assembly deletes
provisions that referred to the one required witness as an
"additional witness", and it also provides for the signature of
an optional "second witness".)
(Source: P.A. 91-790, eff. 6-9-00.)
 
    (755 ILCS 45/3-3.6 new)
    Sec. 3-3.6. Limitations on who may witness property powers.
    (a) Every property power shall bear the signature of a
witness to the signing of the agency and shall be notarized.
None of the following may serve as a witness to the signing of
a property power or as a notary public notarizing the property
power:
        (1) the attending physician or mental health service
    provider of the principal, or a relative of the physician
    or provider;
        (2) an owner, operator, or relative of an owner or
    operator of a health care facility in which the principal
    is a patient or resident;
        (3) a parent, sibling, or descendant, or the spouse of
    a parent, sibling, or descendant, of either the principal
    or any agent or successor agent, regardless of whether the
    relationship is by blood, marriage, or adoption;
        (4) an agent or successor agent for property.
    (b) The prohibition on the operator of a health care
facility from serving as a witness shall extend to directors
and executive officers of an operator that is a corporate
entity but not other employees of the operator.
 
    (755 ILCS 45/3-4)  (from Ch. 110 1/2, par. 803-4)
    Sec. 3-4. Explanation of powers granted in the statutory
short form power of attorney for property. This Section defines
each category of powers listed in the statutory short form
power of attorney for property and the effect of granting
powers to an agent, and is incorporated by reference into the
statutory short form. Incorporation by reference does not
require physical attachment of a copy of this Section 3-4 to
the statutory short form power of attorney for property. When
the title of any of the following categories is retained (not
struck out) in a statutory property power form, the effect will
be to grant the agent all of the principal's rights, powers and
discretions with respect to the types of property and
transactions covered by the retained category, subject to any
limitations on the granted powers that appear on the face of
the form. The agent will have authority to exercise each
granted power for and in the name of the principal with respect
to all of the principal's interests in every type of property
or transaction covered by the granted power at the time of
exercise, whether the principal's interests are direct or
indirect, whole or fractional, legal, equitable or
contractual, as a joint tenant or tenant in common or held in
any other form; but the agent will not have power under any of
the statutory categories (a) through (o) to make gifts of the
principal's property, to exercise powers to appoint to others
or to change any beneficiary whom the principal has designated
to take the principal's interests at death under any will,
trust, joint tenancy, beneficiary form or contractual
arrangement. The agent will be under no duty to exercise
granted powers or to assume control of or responsibility for
the principal's property or affairs; but when granted powers
are exercised, the agent will be required to use due care to
act in good faith for the benefit of the principal using due
care, competence, and diligence in accordance with the terms of
the statutory property power and will be liable for negligent
exercise. The agent may act in person or through others
reasonably employed by the agent for that purpose and will have
authority to sign and deliver all instruments, negotiate and
enter into all agreements and do all other acts reasonably
necessary to implement the exercise of the powers granted to
the agent.
    (a) Real estate transactions. The agent is authorized to:
buy, sell, exchange, rent and lease real estate (which term
includes, without limitation, real estate subject to a land
trust and all beneficial interests in and powers of direction
under any land trust); collect all rent, sale proceeds and
earnings from real estate; convey, assign and accept title to
real estate; grant easements, create conditions and release
rights of homestead with respect to real estate; create land
trusts and exercise all powers under land trusts; hold,
possess, maintain, repair, improve, subdivide, manage, operate
and insure real estate; pay, contest, protest and compromise
real estate taxes and assessments; and, in general, exercise
all powers with respect to real estate which the principal
could if present and under no disability.
    (b) Financial institution transactions. The agent is
authorized to: open, close, continue and control all accounts
and deposits in any type of financial institution (which term
includes, without limitation, banks, trust companies, savings
and building and loan associations, credit unions and brokerage
firms); deposit in and withdraw from and write checks on any
financial institution account or deposit; and, in general,
exercise all powers with respect to financial institution
transactions which the principal could if present and under no
disability. This authorization shall also apply to any Totten
Trust, Payable on Death Account, or comparable trust account
arrangement where the terms of such trust are contained
entirely on the financial institution's signature card,
insofar as an agent shall be permitted to withdraw income or
principal from such account, unless this authorization is
expressly limited or withheld under paragraph 2 of the form
prescribed under Section 3-3. This authorization shall not
apply to accounts titled in the name of any trust subject to
the provisions of the Trusts and Trustees Act, for which
specific reference to the trust and a specific grant of
authority to the agent to withdraw income or principal from
such trust is required pursuant to Section 2-9 of the Illinois
Power of Attorney Act and subsection (n) of this Section.
    (c) Stock and bond transactions. The agent is authorized
to: buy and sell all types of securities (which term includes,
without limitation, stocks, bonds, mutual funds and all other
types of investment securities and financial instruments);
collect, hold and safekeep all dividends, interest, earnings,
proceeds of sale, distributions, shares, certificates and
other evidences of ownership paid or distributed with respect
to securities; exercise all voting rights with respect to
securities in person or by proxy, enter into voting trusts and
consent to limitations on the right to vote; and, in general,
exercise all powers with respect to securities which the
principal could if present and under no disability.
    (d) Tangible personal property transactions. The agent is
authorized to: buy and sell, lease, exchange, collect, possess
and take title to all tangible personal property; move, store,
ship, restore, maintain, repair, improve, manage, preserve,
insure and safekeep tangible personal property; and, in
general, exercise all powers with respect to tangible personal
property which the principal could if present and under no
disability.
    (e) Safe deposit box transactions. The agent is authorized
to: open, continue and have access to all safe deposit boxes;
sign, renew, release or terminate any safe deposit contract;
drill or surrender any safe deposit box; and, in general,
exercise all powers with respect to safe deposit matters which
the principal could if present and under no disability.
    (f) Insurance and annuity transactions. The agent is
authorized to: procure, acquire, continue, renew, terminate or
otherwise deal with any type of insurance or annuity contract
(which terms include, without limitation, life, accident,
health, disability, automobile casualty, property or liability
insurance); pay premiums or assessments on or surrender and
collect all distributions, proceeds or benefits payable under
any insurance or annuity contract; and, in general, exercise
all powers with respect to insurance and annuity contracts
which the principal could if present and under no disability.
    (g) Retirement plan transactions. The agent is authorized
to: contribute to, withdraw from and deposit funds in any type
of retirement plan (which term includes, without limitation,
any tax qualified or nonqualified pension, profit sharing,
stock bonus, employee savings and other retirement plan,
individual retirement account, deferred compensation plan and
any other type of employee benefit plan); select and change
payment options for the principal under any retirement plan;
make rollover contributions from any retirement plan to other
retirement plans or individual retirement accounts; exercise
all investment powers available under any type of self-directed
retirement plan; and, in general, exercise all powers with
respect to retirement plans and retirement plan account
balances which the principal could if present and under no
disability.
    (h) Social Security, unemployment and military service
benefits. The agent is authorized to: prepare, sign and file
any claim or application for Social Security, unemployment or
military service benefits; sue for, settle or abandon any
claims to any benefit or assistance under any federal, state,
local or foreign statute or regulation; control, deposit to any
account, collect, receipt for, and take title to and hold all
benefits under any Social Security, unemployment, military
service or other state, federal, local or foreign statute or
regulation; and, in general, exercise all powers with respect
to Social Security, unemployment, military service and
governmental benefits which the principal could if present and
under no disability.
    (i) Tax matters. The agent is authorized to: sign, verify
and file all the principal's federal, state and local income,
gift, estate, property and other tax returns, including joint
returns and declarations of estimated tax; pay all taxes;
claim, sue for and receive all tax refunds; examine and copy
all the principal's tax returns and records; represent the
principal before any federal, state or local revenue agency or
taxing body and sign and deliver all tax powers of attorney on
behalf of the principal that may be necessary for such
purposes; waive rights and sign all documents on behalf of the
principal as required to settle, pay and determine all tax
liabilities; and, in general, exercise all powers with respect
to tax matters which the principal could if present and under
no disability.
    (j) Claims and litigation. The agent is authorized to:
institute, prosecute, defend, abandon, compromise, arbitrate,
settle and dispose of any claim in favor of or against the
principal or any property interests of the principal; collect
and receipt for any claim or settlement proceeds and waive or
release all rights of the principal; employ attorneys and
others and enter into contingency agreements and other
contracts as necessary in connection with litigation; and, in
general, exercise all powers with respect to claims and
litigation which the principal could if present and under no
disability. The statutory short form power of attorney for
property does not authorize the agent to appear in court or any
tribunal as an attorney-at-law for the principal or otherwise
to engage in the practice of law without being a licensed
attorney who is authorized to practice law in Illinois under
applicable Illinois Supreme Court Rules.
    (k) Commodity and option transactions. The agent is
authorized to: buy, sell, exchange, assign, convey, settle and
exercise commodities futures contracts and call and put options
on stocks and stock indices traded on a regulated options
exchange and collect and receipt for all proceeds of any such
transactions; establish or continue option accounts for the
principal with any securities or futures broker; and, in
general, exercise all powers with respect to commodities and
options which the principal could if present and under no
disability.
    (l) Business operations. The agent is authorized to:
organize or continue and conduct any business (which term
includes, without limitation, any farming, manufacturing,
service, mining, retailing or other type of business operation)
in any form, whether as a proprietorship, joint venture,
partnership, corporation, trust or other legal entity;
operate, buy, sell, expand, contract, terminate or liquidate
any business; direct, control, supervise, manage or
participate in the operation of any business and engage,
compensate and discharge business managers, employees, agents,
attorneys, accountants and consultants; and, in general,
exercise all powers with respect to business interests and
operations which the principal could if present and under no
disability.
    (m) Borrowing transactions. The agent is authorized to:
borrow money; mortgage or pledge any real estate or tangible or
intangible personal property as security for such purposes;
sign, renew, extend, pay and satisfy any notes or other forms
of obligation; and, in general, exercise all powers with
respect to secured and unsecured borrowing which the principal
could if present and under no disability.
    (n) Estate transactions. The agent is authorized to:
accept, receipt for, exercise, release, reject, renounce,
assign, disclaim, demand, sue for, claim and recover any
legacy, bequest, devise, gift or other property interest or
payment due or payable to or for the principal; assert any
interest in and exercise any power over any trust, estate or
property subject to fiduciary control; establish a revocable
trust solely for the benefit of the principal that terminates
at the death of the principal and is then distributable to the
legal representative of the estate of the principal; and, in
general, exercise all powers with respect to estates and trusts
which the principal could if present and under no disability;
provided, however, that the agent may not make or change a will
and may not revoke or amend a trust revocable or amendable by
the principal or require the trustee of any trust for the
benefit of the principal to pay income or principal to the
agent unless specific authority to that end is given, and
specific reference to the trust is made, in the statutory
property power form.
    (o) All other property powers and transactions. The agent
is authorized to: exercise all possible authority powers of the
principal with respect to all possible types of property and
interests in property, except to the extent limited in
subsections (a) through (n) of this Section 3-4 and to the
extent that the principal otherwise limits the generality of
this category (o) by striking out one or more of categories (a)
through (n) or by specifying other limitations in the statutory
property power form.
(Source: P.A. 94-938, eff. 1-1-07.)
 
    (755 ILCS 45/3-5 new)
    Sec. 3-5. Savings clause. This amendatory Act of the 96th
General Assembly does not in any way invalidate any property
power executed or any act of any agent done, or affect any
claim, right, or remedy that accrued, prior to the effective
date of this amendatory Act of the 96th General Assembly.
 
    (755 ILCS 45/4-4)  (from Ch. 110 1/2, par. 804-4)
    Sec. 4-4. Definitions. As used in this Article:
    (a) "Attending physician" means the physician who has
primary responsibility at the time of reference for the
treatment and care of the patient.
    (b) "Health care" means any care, treatment, service or
procedure to maintain, diagnose, treat or provide for the
patient's physical or mental health or personal care.
    (c) "Health care agency" means an agency governing any type
of health care, anatomical gift, autopsy or disposition of
remains for and on behalf of a patient and refers to the power
of attorney or other written instrument defining the agency or
the agency, itself, as appropriate to the context.
    (d) "Health care provider" or "provider" means the
attending physician and any other person administering health
care to the patient at the time of reference who is licensed,
certified, or otherwise authorized or permitted by law to
administer health care in the ordinary course of business or
the practice of a profession, including any person employed by
or acting for any such authorized person.
    (e) "Patient" means the principal or, if the agency governs
health care for a minor child of the principal, then the child.
    (f) "Incurable or irreversible condition" means an illness
or injury (i) for which there is no reasonable prospect of cure
or recovery, (ii) that ultimately will cause the patient's
death even if life-sustaining treatment is initiated or
continued, (iii) that imposes severe pain or otherwise imposes
an inhumane burden on the patient, or (iv) for which initiating
or continuing life-sustaining treatment, in light of the
patient's medical condition, provides only minimal medical
benefit.
    (g) "Permanent unconsciousness" means a condition that, to
a high degree of medical certainty, (i) will last permanently,
without improvement, (ii) in which thought, sensation,
purposeful action, social interaction, and awareness of self
and environment are absent, and (iii) for which initiating or
continuing life-sustaining treatment, in light of the
patient's medical condition, provides only minimal medical
benefit. For the purposes of this definition, "medical benefit"
means a chance to cure or reverse a condition.
    (h) "Terminal condition" means an illness or injury for
which there is no reasonable prospect of cure or recovery,
death is imminent, and the application of life-sustaining
treatment would only prolong the dying process.
(Source: P.A. 85-701.)
 
    (755 ILCS 45/4-5.1 new)
    Sec. 4-5.1. Limitations on who may witness health care
agencies.
    (a) Every health care agency shall bear the signature of a
witness to the signing of the agency. None of the following may
serve as a witness to the signing of a health care agency:
        (1) the attending physician or mental health service
    provider of the principal, or a relative of the physician
    or provider;
        (2) an owner, operator, or relative of an owner or
    operator of a health care facility in which the principal
    is a patient or resident;
        (3) a parent, sibling, or descendant, or the spouse of
    a parent, sibling, or descendant, of either the principal
    or any agent or successor agent, regardless of whether the
    relationship is by blood, marriage, or adoption;
        (4) an agent or successor agent for health care.
    (b) The prohibition on the operator of a health care
facility from serving as a witness shall extend to directors
and executive officers of an operator that is a corporate
entity but not other employees of the operator.
 
    (755 ILCS 45/4-10)  (from Ch. 110 1/2, par. 804-10)
    Sec. 4-10. Statutory short form power of attorney for
health care.
    (a) The following form prescribed in this Section
(sometimes also referred to in this Act as the "statutory
health care power") may be used to grant an agent powers with
respect to the principal's own health care; but the statutory
health care power is not intended to be exclusive nor to cover
delegation of a parent's power to control the health care of a
minor child, and no provision of this Article shall be
construed to invalidate or bar use by the principal of any
other or different form of power of attorney for health care.
Nonstatutory health care powers must be executed by the
principal, designate the agent and the agent's powers, and
comply with Section 4-5 of this Article, but they need not be
witnessed or conform in any other respect to the statutory
health care power. When a power of attorney in substantially
the following form prescribed in this Section is used,
including the "Notice to the Individual Signing the Illinois
Statutory Short Form Power of Attorney for Health Care" (or
"Notice" paragraphs) "notice" paragraph at the beginning of the
form on a separate sheet in 14-point type in capital letters,
it shall have the meaning and effect prescribed in this Act. A
power of attorney for health care shall be deemed to be in
substantially the same format as the statutory form if the
explanatory language throughout the form (the language
following the designation "NOTE:") is distinguished in some way
from the legal paragraphs in the form, such as the use of
boldface or other difference in typeface and font or point
size, even if the "Notice" paragraphs at the beginning are not
on a separate sheet of paper or are not in 14-point type, or if
the principal's initials do not appear in the acknowledgement
at the end of the "Notice" paragraphs. The statutory health
care power may be included in or combined with any other form
of power of attorney governing property or other matters.
    (b) The Illinois Statutory Short Form Power of Attorney for
Health Care shall be substantially as follows:
 
"NOTICE TO THE INDIVIDUAL SIGNING THE ILLINOIS
STATUTORY SHORT FORM POWER OF ATTORNEY FOR HEALTH CARE

 
    PLEASE READ THIS NOTICE CAREFULLY. The form that you will
be signing is a legal document. It is governed by the Illinois
Power of Attorney Act. If there is anything about this form
that you do not understand, you should ask a lawyer to explain
it to you.
    The purpose of this Power of Attorney is to give your
designated "agent" broad powers to make health care decisions
for you, including the power to require, consent to, or
withdraw treatment for any physical or mental condition, and to
admit you or discharge you from any hospital, home, or other
institution. You may name successor agents under this form, but
you may not name co-agents.
    This form does not impose a duty upon your agent to make
such health care decisions, so it is important that you select
an agent who will agree to do this for you and who will make
those decisions as you would wish. It is also important to
select an agent whom you trust, since you are giving that agent
control over your medical decision-making, including
end-of-life decisions. Any agent who does act for you has a
duty to act in good faith for your benefit and to use due care,
competence, and diligence. He or she must also act in
accordance with the law and with the statements in this form.
Your agent must keep a record of all significant actions taken
as your agent.
    Unless you specifically limit the period of time that this
Power of Attorney will be in effect, your agent may exercise
the powers given to him or her throughout your lifetime, even
after you become disabled. A court, however, can take away the
powers of your agent if it finds that the agent is not acting
properly. You may also revoke this Power of Attorney if you
wish.
    The Powers you give your agent, your right to revoke those
powers, and the penalties for violating the law are explained
more fully in Sections 4-5, 4-6, and 4-10(b) of the Illinois
Power of Attorney Act. This form is a part of that law. The
"NOTE" paragraphs throughout this form are instructions.
    You are not required to sign this Power of Attorney, but it
will not take effect without your signature. You should not
sign it if you do not understand everything in it, and what
your agent will be able to do if you do sign it.
 
    Please put your initials on the following line indicating
that you have read this Notice:
......................
(Principal's initials)"

 
"ILLINOIS STATUTORY SHORT FORM
POWER OF ATTORNEY FOR HEALTH CARE

 
    (NOTICE: THE PURPOSE OF THIS POWER OF ATTORNEY IS TO GIVE
THE PERSON YOU DESIGNATE (YOUR "AGENT") BROAD POWERS TO MAKE
HEALTH CARE DECISIONS FOR YOU, INCLUDING POWER TO REQUIRE,
CONSENT TO OR WITHDRAW ANY TYPE OF PERSONAL CARE OR MEDICAL
TREATMENT FOR ANY PHYSICAL OR MENTAL CONDITION AND TO ADMIT YOU
TO OR DISCHARGE YOU FROM ANY HOSPITAL, HOME OR OTHER
INSTITUTION. THIS FORM DOES NOT IMPOSE A DUTY ON YOUR AGENT TO
EXERCISE GRANTED POWERS; BUT WHEN POWERS ARE EXERCISED, YOUR
AGENT WILL HAVE TO USE DUE CARE TO ACT FOR YOUR BENEFIT AND IN
ACCORDANCE WITH THIS FORM AND KEEP A RECORD OF RECEIPTS,
DISBURSEMENTS AND SIGNIFICANT ACTIONS TAKEN AS AGENT. A COURT
CAN TAKE AWAY THE POWERS OF YOUR AGENT IF IT FINDS THE AGENT IS
NOT ACTING PROPERLY. YOU MAY NAME SUCCESSOR AGENTS UNDER THIS
FORM BUT NOT CO-AGENTS, AND NO HEALTH CARE PROVIDER MAY BE
NAMED. UNLESS YOU EXPRESSLY LIMIT THE DURATION OF THIS POWER IN
THE MANNER PROVIDED BELOW, UNTIL YOU REVOKE THIS POWER OR A
COURT ACTING ON YOUR BEHALF TERMINATES IT, YOUR AGENT MAY
EXERCISE THE POWERS GIVEN HERE THROUGHOUT YOUR LIFETIME, EVEN
AFTER YOU BECOME DISABLED. THE POWERS YOU GIVE YOUR AGENT, YOUR
RIGHT TO REVOKE THOSE POWERS AND THE PENALTIES FOR VIOLATING
THE LAW ARE EXPLAINED MORE FULLY IN SECTIONS 4-5, 4-6, 4-9 AND
4-10(b) OF THE ILLINOIS "POWERS OF ATTORNEY FOR HEALTH CARE
LAW" OF WHICH THIS FORM IS A PART (SEE THE BACK OF THIS FORM).
THAT LAW EXPRESSLY PERMITS THE USE OF ANY DIFFERENT FORM OF
POWER OF ATTORNEY YOU MAY DESIRE. IF THERE IS ANYTHING ABOUT
THIS FORM THAT YOU DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER
TO EXPLAIN IT TO YOU.)
    POWER OF ATTORNEY made this .......................day of
................................
    (month)  (year)
    1. I, ..................................................,
(insert name and address of principal) hereby revoke all prior
powers of attorney for health care executed by me and appoint:
............................................................
(insert name and address of agent)
(NOTE: You may not name co-agents using this form.)
as my attorney-in-fact (my "agent") to act for me and in my
name (in any way I could act in person) to make any and all
decisions for me concerning my personal care, medical
treatment, hospitalization and health care and to require,
withhold or withdraw any type of medical treatment or
procedure, even though my death may ensue.
    A. My agent shall have the same access to my medical
records that I have, including the right to disclose the
contents to others. My agent shall also have full power to
authorize an autopsy and direct the disposition of my remains.
    B. Effective upon my death, my agent has the full power to
make an anatomical gift of the following (initial one):
(NOTE: Initial one. In the event none of the options are
initialed, then it shall be concluded that you do not wish to
grant your agent any such authority.)
        .... Any organs, tissues, or eyes suitable for
    transplantation or used for research or education.
        .... Specific organs:................................
        .... I do not grant my agent authority to make any
    anatomical gifts.
    C. My agent shall also have full power to authorize an
autopsy and direct the disposition of my remains. I intend for
this power of attorney to be in substantial compliance with
Section 10 of the Disposition of Remains Act. All decisions
made by my agent with respect to the disposition of my remains,
including cremation, shall be binding. I hereby direct any
cemetery organization, business operating a crematory or
columbarium or both, funeral director or embalmer, or funeral
establishment who receives a copy of this document to act under
it.
    D. I intend for the person named as my agent to be treated
as I would be with respect to my rights regarding the use and
disclosure of my individually identifiable health information
or other medical records, including records or communications
governed by the Mental Health and Developmental Disabilities
Confidentiality Act. This release authority applies to any
information governed by the Health Insurance Portability and
Accountability Act of 1996 ("HIPAA") and regulations
thereunder. I intend for the person named as my agent to serve
as my "personal representative" as that term is defined under
HIPAA and regulations thereunder.
    (i) The person named as my agent shall have the power to
authorize the release of information governed by HIPAA to third
parties.
    (ii) I authorize any physician, health care professional,
dentist, health plan, hospital, clinic, laboratory, pharmacy
or other covered health care provider, any insurance company
and the Medical Informational Bureau, Inc., or any other health
care clearinghouse that has provided treatment or services to
me, or that has paid for or is seeking payment for me for such
services to give, disclose, and release to the person named as
my agent, without restriction, all of my individually
identifiable health information and medical records, regarding
any past, present, or future medical or mental health
condition, including all information relating to the diagnosis
and treatment of HIV/AIDS, sexually transmitted diseases, drug
or alcohol abuse, and mental illness (including records or
communications governed by the Mental Health and Developmental
Disabilities Confidentiality Act).
    (iii) The authority given to the person named as my agent
shall supersede any prior agreement that I may have with my
health care providers to restrict access to, or disclosure of,
my individually identifiable health information. The authority
given to the person named as my agent has no expiration date
and shall expire only in the event that I revoke the authority
in writing and deliver it to my health care provider. The
authority given to the person named as my agent to serve as my
"personal representative" as defined under HIPAA and
regulations thereunder and to access my individually
identifiable health information or authorize the release of the
same to third parties shall take effect immediately, even if I
designate in Paragraph 3 of this document that this agency
shall otherwise take effect at some future date.
(NOTE: The above grant of power is intended to be as broad as
possible so that your agent will have the authority to make any
decision you could make to obtain or terminate any type of
health care, including withdrawal of food and water and other
life-sustaining measures, if your agent believes such action
would be consistent with your intent and desires. If you wish
to limit the scope of your agent's powers or prescribe special
rules or limit the power to make an anatomical gift, authorize
autopsy or dispose of remains, you may do so in the following
paragraphs.) (THE ABOVE GRANT OF POWER IS INTENDED TO BE AS
BROAD AS POSSIBLE SO THAT YOUR AGENT WILL HAVE AUTHORITY TO
MAKE ANY DECISION YOU COULD MAKE TO OBTAIN OR TERMINATE ANY
TYPE OF HEALTH CARE, INCLUDING WITHDRAWAL OF FOOD AND WATER AND
OTHER LIFE-SUSTAINING MEASURES, IF YOUR AGENT BELIEVES SUCH
ACTION WOULD BE CONSISTENT WITH YOUR INTENT AND DESIRES. IF YOU
WISH TO LIMIT THE SCOPE OF YOUR AGENT'S POWERS OR PRESCRIBE
SPECIAL RULES OR LIMIT THE POWER TO MAKE AN ANATOMICAL GIFT,
AUTHORIZE AUTOPSY OR DISPOSE OF REMAINS, YOU MAY DO SO IN THE
FOLLOWING PARAGRAPHS.)
    2. The powers granted above shall not include the following
powers or shall be subject to the following rules or
limitations:
(NOTE: Here (here you may include any specific limitations you
deem appropriate, such as: your own definition of when
life-sustaining measures should be withheld; a direction to
continue food and fluids or life-sustaining treatment in all
events; or instructions to refuse any specific types of
treatment that are inconsistent with your religious beliefs or
unacceptable to you for any other reason, such as blood
transfusion, electro-convulsive therapy, amputation,
psychosurgery, voluntary admission to a mental institution,
etc.):
.............................................................
.............................................................
.............................................................
.............................................................
.............................................................
(NOTE: The subject of life-sustaining treatment is of
particular importance. For your convenience in dealing with
that subject, some general statements concerning the
withholding or removal of life-sustaining treatment are set
forth below. If you agree with one of these statements, you may
initial that statement; but do not initial more than one. These
statements serve as guidance for your agent, who shall give
careful consideration to the statement you initial when
engaging in health care decision-making on your behalf.) (THE
SUBJECT OF LIFE-SUSTAINING TREATMENT IS OF PARTICULAR
IMPORTANCE. FOR YOUR CONVENIENCE IN DEALING WITH THAT SUBJECT,
SOME GENERAL STATEMENTS CONCERNING THE WITHHOLDING OR REMOVAL
OF LIFE-SUSTAINING TREATMENT ARE SET FORTH BELOW. IF YOU AGREE
WITH ONE OF THESE STATEMENTS, YOU MAY INITIAL THAT STATEMENT;
BUT DO NOT INITIAL MORE THAN ONE):
    I do not want my life to be prolonged nor do I want
life-sustaining treatment to be provided or continued if my
agent believes the burdens of the treatment outweigh the
expected benefits. I want my agent to consider the relief of
suffering, the expense involved and the quality as well as the
possible extension of my life in making decisions concerning
life-sustaining treatment.
Initialed ...........................
    I want my life to be prolonged and I want life-sustaining
treatment to be provided or continued, unless I am in a coma
which my attending physician believes to be irreversible, in
the opinion of my attending physician, in accordance with
reasonable medical standards at the time of reference, in a
state of "permanent unconsciousness" or suffer from an
"incurable or irreversible condition" or "terminal condition",
as those terms are defined in Section 4-4 of the Illinois Power
of Attorney Act. If and when I am in any one of these states or
conditions, I have suffered irreversible coma, I want
life-sustaining treatment to be withheld or discontinued.
Initialed ...........................
    I want my life to be prolonged to the greatest extent
possible in accordance with reasonable medical standards
without regard to my condition, the chances I have for recovery
or the cost of the procedures.
Initialed ...........................
(NOTE: This power of attorney may be amended or revoked by you
in the manner provided in Section 4-6 of the Illinois Power of
Attorney Act. Your agent can act immediately, unless you
specify otherwise; but you cannot specify otherwise with
respect to your "personal representative" under subparagraph
D(iii).) (THIS POWER OF ATTORNEY MAY BE AMENDED OR REVOKED BY
YOU IN THE MANNER PROVIDED IN SECTION 4-6 OF THE ILLINOIS
"POWERS OF ATTORNEY FOR HEALTH CARE LAW" (SEE THE BACK OF THIS
FORM). ABSENT AMENDMENT OR REVOCATION, THE AUTHORITY GRANTED IN
THIS POWER OF ATTORNEY WILL BECOME EFFECTIVE AT THE TIME THIS
POWER IS SIGNED AND WILL CONTINUE UNTIL YOUR DEATH, AND BEYOND
IF ANATOMICAL GIFT, AUTOPSY OR DISPOSITION OF REMAINS IS
AUTHORIZED, UNLESS A LIMITATION ON THE BEGINNING DATE OR
DURATION IS MADE BY INITIALING AND COMPLETING EITHER OR BOTH OF
THE FOLLOWING:)
    3.  ( ) This power of attorney shall become effective on
.............................................................
.............................................................
(NOTE: Insert insert a future date or event during your
lifetime, such as a court determination of your disability or a
written determination by your physician that you are
incapacitated, when you want this power to first take effect.)
(NOTE: If you do not amend or revoke this power, or if you do
not specify a specific ending date in paragraph 4, it will
remain in effect until your death; except that your agent will
still have the authority to donate your organs, authorize an
autopsy, and dispose of your remains after your death, if you
grant that authority to your agent.)
    4.  ( ) This power of attorney shall terminate on .......
.............................................................
(NOTE: Insert insert a future date or event, such as a court
determination that you are not under a legal disability or a
written determination by your physician that you are not
incapacitated, if of your disability, when you want this power
to terminate prior to your death.)
(NOTE: You cannot use this form to name co-agents. If you wish
to name successor agents, insert the names and addresses of the
successors in paragraph 5.) (IF YOU WISH TO NAME SUCCESSOR
AGENTS, INSERT THE NAMES AND ADDRESSES OF SUCH SUCCESSORS IN
THE FOLLOWING PARAGRAPH.)
    5. If any agent named by me shall die, become incompetent,
resign, refuse to accept the office of agent or be unavailable,
I name the following (each to act alone and successively, in
the order named) as successors to such agent:
.............................................................
.............................................................
For purposes of this paragraph 5, a person shall be considered
to be incompetent if and while the person is a minor, or an
adjudicated incompetent or disabled person, or the person is
unable to give prompt and intelligent consideration to health
care matters, as certified by a licensed physician.
(NOTE: If you wish to, you may name your agent as guardian of
your person if a court decides that one should be appointed. To
do this, retain paragraph 6, and the court will appoint your
agent if the court finds that this appointment will serve your
best interests and welfare. Strike out paragraph 6 if you do
not want your agent to act as guardian.) (IF YOU WISH TO NAME
YOUR AGENT AS GUARDIAN OF YOUR PERSON, IN THE EVENT A COURT
DECIDES THAT ONE SHOULD BE APPOINTED, YOU MAY, BUT ARE NOT
REQUIRED TO, DO SO BY RETAINING THE FOLLOWING PARAGRAPH. THE
COURT WILL APPOINT YOUR AGENT IF THE COURT FINDS THAT SUCH
APPOINTMENT WILL SERVE YOUR BEST INTERESTS AND WELFARE. STRIKE
OUT PARAGRAPH 6 IF YOU DO NOT WANT YOUR AGENT TO ACT AS
GUARDIAN.)
    6. If a guardian of my person is to be appointed, I
nominate the agent acting under this power of attorney as such
guardian, to serve without bond or security.
    7. I am fully informed as to all the contents of this form
and understand the full import of this grant of powers to my
agent.
Dated: .......... 
Signed ..............................
(
principal's signature or mark
principal
)
  
 
    The principal has had an opportunity to review read the
above form and has signed the form or acknowledged his or her
signature or mark on the form in my presence. The undersigned
witness certifies that the witness is not: (a) the attending
physician or mental health service provider or a relative of
the physician or provider; (b) an owner, operator, or relative
of an owner or operator of a health care facility in which the
principal is a patient or resident; (c) a parent, sibling,
descendant, or any spouse of such parent, sibling, or
descendant of either the principal or any agent or successor
agent under the foregoing power of attorney, whether such
relationship is by blood, marriage, or adoption; or (d) an
agent or successor agent under the foregoing power of attorney.
.......................
(Witness Signature)
.......................
(Print Witness Name)
.......................
(Street Address)
.......................
(City, State, ZIP)
..........................  Residing at......................
        (witness)
(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.) (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 of my
agent (and successors).   agent (and successors) are correct.
.......................   ...................................
       (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 is optional.)
.........................
(name of preparer)
.........................
.........................
(address)
.........................
(phone)
    (c) (b) The statutory short form power of attorney for
health care (the "statutory health care power") authorizes the
agent to make any and all health care decisions on behalf of
the principal which the principal could make if present and
under no disability, subject to any limitations on the granted
powers that appear on the face of the form, to be exercised in
such manner as the agent deems consistent with the intent and
desires of the principal. The agent will be under no duty to
exercise granted powers or to assume control of or
responsibility for the principal's health care; but when
granted powers are exercised, the agent will be required to use
due care to act for the benefit of the principal in accordance
with the terms of the statutory health care power and will be
liable for negligent exercise. The agent may act in person or
through others reasonably employed by the agent for that
purpose but may not delegate authority to make health care
decisions. The agent may sign and deliver all instruments,
negotiate and enter into all agreements and do all other acts
reasonably necessary to implement the exercise of the powers
granted to the agent. Without limiting the generality of the
foregoing, the statutory health care power shall include the
following powers, subject to any limitations appearing on the
face of the form:
        (1) The agent is authorized to give consent to and
    authorize or refuse, or to withhold or withdraw consent to,
    any and all types of medical care, treatment or procedures
    relating to the physical or mental health of the principal,
    including any medication program, surgical procedures,
    life-sustaining treatment or provision of food and fluids
    for the principal.
        (2) The agent is authorized to admit the principal to
    or discharge the principal from any and all types of
    hospitals, institutions, homes, residential or nursing
    facilities, treatment centers and other health care
    institutions providing personal care or treatment for any
    type of physical or mental condition. The agent shall have
    the same right to visit the principal in the hospital or
    other institution as is granted to a spouse or adult child
    of the principal, any rule of the institution to the
    contrary notwithstanding.
        (3) The agent is authorized to contract for any and all
    types of health care services and facilities in the name of
    and on behalf of the principal and to bind the principal to
    pay for all such services and facilities, and to have and
    exercise those powers over the principal's property as are
    authorized under the statutory property power, to the
    extent the agent deems necessary to pay health care costs;
    and the agent shall not be personally liable for any
    services or care contracted for on behalf of the principal.
        (4) At the principal's expense and subject to
    reasonable rules of the health care provider to prevent
    disruption of the principal's health care, the agent shall
    have the same right the principal has to examine and copy
    and consent to disclosure of all the principal's medical
    records that the agent deems relevant to the exercise of
    the agent's powers, whether the records relate to mental
    health or any other medical condition and whether they are
    in the possession of or maintained by any physician,
    psychiatrist, psychologist, therapist, hospital, nursing
    home or other health care provider.
        (5) The agent is authorized: to direct that an autopsy
    be made pursuant to Section 2 of "An Act in relation to
    autopsy of dead bodies", approved August 13, 1965,
    including all amendments; to make a disposition of any part
    or all of the principal's body pursuant to the Illinois
    Anatomical Gift Act, as now or hereafter amended; and to
    direct the disposition of the principal's remains.
(Source: P.A. 93-794, eff. 7-22-04.)
 
    (755 ILCS 45/4-12)  (from Ch. 110 1/2, par. 804-12)
    Sec. 4-12. Saving clause. This Act does not in any way
invalidate any health care agency executed or any act of any
agent done, or affect any claim, right or remedy that accrued,
prior to September 22, 1987.
    This amendatory Act of the 96th General Assembly does not
in any way invalidate any health care agency executed or any
act of any agent done, or affect any claim, right, or remedy
that accrued, prior to the effective date of this amendatory
Act of the 96th General Assembly.
(Source: P.A. 86-736.)
 
    (755 ILCS 45/2-7.5 rep.)
    Section 10. The Illinois Power of Attorney Act is amended
by repealing Section 2-7.5.
 
    Section 99. Effective date. This Act takes effect July 1,
2011.