Follow the steps to complete the authorization form

1. Click ‘Get Form’ button to obtain the form and open it for filling out.
2. Begin by entering the employer's name in the designated field. If the name is different from that of the participant, ensure to fill in both names.
3. Enter the social security number of the employer. This is a required field for identification purposes.
4. Provide the date of birth for the employer. Ensure the format is clear and correct.
5. Fill in the street address, city, state, and ZIP code for the employer. Make sure the address is complete and accurate.
6. If applicable, input the mailing address of the employer, including city, state, and ZIP code.
7. Include the name of the support coordinator if this is different from the employer’s name.
8. Provide the county of residence for the employer, ensuring it matches current records.
9. Enter the email address and phone number of the employer to ensure proper communication.
10. If necessary, repeat steps 2 through 9 for the participant receiving services, ensuring all information is provided.
11. Review all entries for accuracy. Once confirmed, the employer must sign the form, indicating their understanding and acceptance.
12. Finally, complete the date field beside the employer's signature before submission.
13. Once all fields are completed, save any changes made, then proceed to share, download, or print the form for submission.

Complete your documents online to ensure a smooth authorization process.