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  • Appointment Of Authorized Representative Form - City Of Philadelphia - Phila

Get Appointment Of Authorized Representative Form - City Of Philadelphia - Phila

C I T Y O F P H I L A D E L P H I A First Level Review Appointment of Authorized Representative I hereby appoint the following individual or company as my authorized representative to act on my behalf.

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How to fill out the Appointment Of Authorized Representative Form - City Of Philadelphia - Phila online

Filling out the Appointment Of Authorized Representative Form is a crucial step in designating someone to act on your behalf during the First Level Review process. This guide provides clear directions to ensure you complete the form accurately and efficiently, helping you navigate the online process with ease.

Follow the steps to complete the form successfully.

  1. Press the ‘Get Form’ button to obtain the Appointment Of Authorized Representative Form and open it in your editing tool.
  2. Indicate the purpose of the authorization by checking the appropriate boxes. If you only want your representative to file the First Level Review Request, check the first box. If you want them to discuss and/or attend a meeting regarding your property, check the second box. If both tasks are desired, check both boxes.
  3. Provide the name and firm/company of your authorized representative in the designated fields.
  4. Fill in the complete address of your authorized representative, including street, city, state, zip code, phone number, and email address for contact purposes.
  5. Write your name as the property owner in the specified area.
  6. Sign your name on the line provided as the property owner, ensuring that your signature is original, using 'wet' ink. You may also write the date alongside your signature at this time or during notarization.
  7. Fill in the property address and the associated OPA number. Additionally, specify which tax year this request pertains to.
  8. Have the form notarized. The notary will complete the relevant section at the bottom, confirming your signature.
  9. After finalizing the form, save any changes made online, and prepare to submit it along with the First Level Review Request to the Office of Property Assessment.

Complete your documents online today to streamline your appointment process.

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(Failure to complete this form in its entirety will invalidate this authorization) An Authorized Representative is a person you authorize to act on your behalf, in pursuing a claim or an appeal of a denied claim.

Someone who you choose to act on your behalf with the Marketplace, like a family member or other trusted person. Some authorized representatives may have legal authority to act on your behalf.

Designation Form. You can submit this form if you would like to designate an authorized representative to act on your behalf.

MassHealth Authorized Representative Designation Form [ARD (11/22)] A form used to designate an authorized representative who can help the applicant or member with the responsibilities of applying for or getting MassHealth.

An Authorized Representative is someone you can name and give access to your Protected Health Information (PHI). An Authorized Representative can be family members, friends, or any other individual you choose.

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Get Appointment Of Authorized Representative Form - City Of Philadelphia - Phila
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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Appointment Of Authorized Representative Form - City Of Philadelphia - Phila
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