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