Get 2017 New Proxy Authorization Form - Sscac.org

Filling out the 2017 New Proxy Authorization Form online is a straightforward process designed to grant an authorized individual permission to act on your behalf for energy assistance matters. This guide provides clear, step-by-step instructions to assist you in completing the form efficiently.

Follow the steps to fill out the form correctly.

1. Press the 'Get Form' button to obtain the Proxy Authorization Form and open it for editing.
2. In the 'Applicant Name' field, enter the full legal name of the person applying for proxy authorization.
3. Fill in the 'Application Number' field with the relevant application number associated with your energy assistance request.
4. In the next section, provide the full name of the individual you are designating as your Authorized Proxy in the designated field.
5. Input the 'Proxy’s Telephone Number' to ensure that the SSCAC can contact your authorized proxy if needed.
6. Indicate the 'Relationship to Applicant' by specifying your relationship with the authorized proxy, such as friend, relative, etc.
7. Acknowledge your rights regarding the proxy authorization by reading the statement about withdrawing authorization. Ensure you understand the process in case you need to retract it in the future.
8. Sign and date the form in the 'Applicant Signature' field. Ensure that both your signature and the date are clearly visible.
9. Prepare to attach copies of both the proxy's photo identification and your own. Ensure these are combined with your form as required.
10. After completing all fields and attaching necessary documents, save your changes to the form. You may then download, print, or share the completed document as needed.

Begin filling out your Proxy Authorization Form online today to streamline your energy assistance application process.