Get 470-1950 Authorization For Reimbursement Of Interim Assistance ... - Dhs State Ia

The 470-1950 Authorization for Reimbursement of Interim Assistance is an essential document for users seeking reimbursement for interim assistance provided during the Supplemental Security Income (SSI) process. This guide will help you navigate the online form, ensuring that you complete each section accurately.

Follow the steps to successfully fill out the form online.

1. To begin, press the ‘Get Form’ button to access the 470-1950 form and open it in your editor.
2. Fill in your name, street address, city, zip code, and telephone number in the designated fields at the top of the form.
3. In the section labeled 'County agency,' specify the name of the county agency you are working with.
4. Choose the applicable option by checking the box for either 'Initial Claim Only' or 'Posteligibility Case Only.' Ensure that only one box is selected, as checking both will invalidate the form.
5. Carefully read the 'Terms of Authorization' section, and ensure you understand the details related to your interim assistance period and the conditions under which your authorization is valid.
6. Provide your signature and the date you are signing. This authorizes the Social Security Administration (SSA) to reimburse the county agency for assistance given during the interim period.
7. A designated staff member from the county agency must also sign and date the form to validate it.
8. Review all entered information for accuracy before finalizing the form. Once confirmed, you can save the changes, download the completed form, or print it for your records.
9. Lastly, ensure the county agency submits the completed form to the SSA within 30 calendar days from the date you signed it to maintain its validity.

Complete your documents online today to ensure timely processing and reimbursement.