Get Authorized Representative

This guide will walk you through the process of completing the Authorized Representative form. By following these steps, you can ensure that your appointed representative can assist you effectively with your application to the Family Independence Agency.

Follow the steps to complete the Authorized Representative form.

1. Press the ‘Get Form’ button to retrieve the Authorized Representative form and open it in your document editor.
2. Begin by entering your name in the space provided at the top of the form. This identifies you as the applicant who is granting authorization.
3. Input the name of the person you are appointing as your Authorized Representative in the designated field. Ensure that you provide their full legal name.
4. Fill in the address of your Authorized Representative, including their street address, city, state (Michigan), and zip code. This information allows the FIA to contact them if necessary.
5. Provide the phone number of your Authorized Representative, ensuring it is a number where they can be reached easily.
6. In the section explaining your appointment, state the reason for appointing a representative. You may personalize this section by explaining that members of your household cannot physically go to the FIA office.
7. Indicate that your representative must provide truthful information about your household by acknowledging the statement provided in the form.
8. Your Authorized Representative must confirm their eligibility by checking the boxes that describe their relationship to you, whether they are a relative, friend, or other, and specify their relationship if necessary.
9. Both you and your Authorized Representative must sign and date the form to validate your appointment. Ensure that each signature is clear and includes the correct date.
10. Once all sections are filled out, save your changes. You can then download, print, or share the completed Authorized Representative form as needed.

Take action now by completing your Authorized Representative form online to ensure your application is processed smoothly.