Cyber Law & Digital Crime Litigation · Chicago, Illinois
Limited Power of Attorney
For Legal Representation and Related Administrative Acts
-
Parties and principal identification
I, the undersigned Principal, state my full legal name: _________________________________
Former names (if any): _________________________________
Residential address: ________________________________________________________________
City: ______________________ State: _________ ZIP: __________ Country: _______________
Date of birth (optional, if needed for identification): ___ / ___ / ______
Government-issued ID type and number: __________________________ Expiration: ___ / ___ / ______
Email: ________________________________ Mobile phone: ________________________________
-
Agent (attorney-in-fact for limited purposes)
I hereby designate the following as my Agent for the limited purposes in Section 3:
Agent name: Patriots Attorneys (professional corporation / limited liability partnership — insert exact entity name)
Address: _______________________, Chicago, Illinois _________
Attention: _______________________, Illinois licensed attorney, Bar No. ____________
Email / phone: ________________________________________________________________
-
Grant of authority (limited scope)
Subject to the limitations in Section 4, I grant the Agent authority to act on my behalf solely with respect to the following matter(s) and objectives (describe with specificity):
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________Such authority includes, only as necessary for that matter, the power to:
- Communicate with courts, agencies, opposing parties, mediators, and third parties regarding the matter;
- Request, receive, and review records and correspondence related to the matter;
- Execute engagement-related documents, declarations under penalty of perjury where permitted, settlement-related instruments, releases, and stipulations only if and to the extent I have given separate written consent to the specific terms, or as otherwise required by applicable rules of professional conduct;
- Delegate tasks to lawyers, paralegals, and investigators employed or retained by the Agent consistent with professional rules.
-
Limitations
- This instrument does not grant authority to create debt in my name unrelated to the matter, to sell or encumber real estate, to make health-care decisions, or to change beneficiary designations, unless expressly initialed below: ☐ N/A ☐ Authorized (describe): _________________________________
- The Agent shall comply with the Illinois Rules of Professional Conduct and all other applicable ethics rules.
- Any appearance in Illinois state or federal court must be made consistent with court rules governing who may appear; filing requirements are not waived by this document.
-
Duration
This limited power of attorney is effective upon execution and remains in effect until the earliest of: (a) completion of the matter described in Section 3; (b) termination of the attorney–client relationship in writing; (c) revocation under Section 8; or (d) the following date: ___ / ___ / ______ (optional sunset).
-
Indemnification and ratification
I agree to indemnify and hold harmless the Agent for lawful actions taken in good faith within the scope of authority granted, except for willful misconduct or gross negligence. I ratify acts the Agent lawfully takes within that scope prior to written notice of revocation received by the Agent.
-
Governing law; venue; interpretation
This instrument is governed by the laws of the State of Illinois, without regard to conflict-of-law principles that would require another state’s law. Venue for any dispute arising from this authorization, if permitted, shall be in Cook County, Illinois, unless otherwise agreed in a separate writing signed by both parties.
If any provision is held invalid, the remainder shall remain in effect to the maximum extent permitted.
-
Revocation
I may revoke this limited power of attorney by a signed writing delivered to the Agent at the address above (and, where applicable, filed with any tribunal handling the matter). Revocation does not undo lawful acts already taken in reliance on this document.
Execution
By signing below, I acknowledge that I have read this document (or had it read to me), that I am signing voluntarily, and that I may consult independent counsel before signing.
Principal signature: _________________________________
Print name: _________________________________
Date: ___ / ___ / ______
Witness (optional unless required): _________________________________
Witness signature: _________________________________
Date: ___ / ___ / ______
Notary acknowledgment (if required for your use case)
State of __________________ County of __________________
On __________________, before me, the undersigned notary public, personally appeared __________________, known to me or proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he/she/they executed the same for the purposes stated therein.
Notary signature: _________________________________
Notary public commission expires: ___ / ___ / ______
(Seal)
Firm acknowledgment (for office file only)
Accepted by: _________________________________ Bar No. ____________ Date: ___ / ___ / ______