Admin Appointment/Removal FormSchool Employees Benefits Board ProgramSCHOOL EMPLOYEES BENEFITS BOARDAppointment of SEBB My Account Administrator The following individual has been duly appointed by.

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How to fill out the WA HCA 20-0117 online

Filling out the WA HCA 20-0117 form online is a straightforward process that enables you to appoint or remove a School Employees Benefits Board (SEBB) My Account Administrator. This guide provides clear, step-by-step instructions to assist you in completing the form accurately.

Follow the steps to fill out the WA HCA 20-0117 form online.

  1. Click the ‘Get Form’ button to obtain the form and open it in the online form editor.
  2. In the designated field, print the name of the Superintendent who is authorizing the appointment or removal of the SEBB My Account Administrator.
  3. For the appointment section, print the first and last name of the individual being appointed as the SEBB My Account Administrator.
  4. Enter the email address of the appointed individual to ensure they receive necessary communications.
  5. The appointed administrator must sign the form acknowledging their understanding of the SEBB My Account Security Management Policy.
  6. Fill in the effective date of the appointment for clear documentation.
  7. For the removal section, print the first and last name of the individual being removed, along with their email address.
  8. Specify the effective date for the removal to ensure proper records.
  9. The Superintendent must sign and date the form to validate the appointment or removal.
  10. After completing the form, save your changes, then download, print, or share the form as needed.

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