Get Form 139rep - Authorized Representative Form - Dcf Vermont

Filling out the Form 139REP allows individuals to designate a trusted person as their Authorized Representative for matters related to their application with the Department for Children and Families in Vermont. This guide will provide you with clear, step-by-step instructions to complete the form efficiently and accurately online.

Follow the steps to fill out the Form 139REP online

1. Click the ‘Get Form’ button to access the Authorized Representative Form and open it in your preferred editor. Ensure you have all your details at hand.
2. Enter the applicant's name, including first and last names, ensuring correct spelling and formatting.
3. Provide the applicant's Social Security number to confirm identity and eligibility.
4. Input the date of birth of the applicant in the specified format (mm/dd/yyyy).
5. Fill in the Authorized Representative's full name, including first, middle, last, and any suffix (e.g., Jr., Sr.).
6. Complete the address fields for the Authorized Representative, including street address, apartment or suite number, city, state, and ZIP code.
7. Record a reliable phone number for the Authorized Representative, using the appropriate format.
8. If applicable, enter the name of the organization the Authorized Representative represents.
9. If there is an ID number for the Authorized Representative, include it in the corresponding field.
10. Select one of the options regarding the status of the Authorized Representative: whether they are new, replacing an existing representative, or if permissions are being revoked.
11. Carefully read the terms provided, especially regarding the responsibilities of the Authorized Representative, before signing the form.
12. Sign and date the form to validate the agreement and the transaction.
13. After filling out the form, ensure to save your changes, and prepare to download, print, or share the form as necessary.

Complete your Form 139REP online today to ensure your application process is handled smoothly.