Get Application Form For Authority To Appoint An Agent - Welfare.ie - Welfare

Filling out the Application Form For Authority To Appoint An Agent is a crucial step in managing social welfare benefits for an individual. This guide provides detailed instructions to ensure the form is completed accurately and efficiently.

Follow the steps to fill out the application form effectively

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In Part 1, provide your customer details including your Personal Public Service (PPS) Number, surname, first name(s), and date of birth. Additionally, fill in your current address, contact numbers, email, and the name of the social welfare allowance or pension you are receiving.
3. If you reside in a nursing home, hospital, or care center, indicate your admission date, the name of the facility, and its address and contact number.
4. Complete the customer declaration section, affirming that you are under no pressure to appoint an agent and verify that all the information is accurate. Name the person you wish to appoint as your agent here.
5. Sign and date the declaration. If you are unable to sign, mark your name and have a witness sign beside it, ensuring that the witness is not the appointed agent.
6. In Part 2, enter the agent's details, including their PPS Number, surname, first name(s), address, contact numbers, email, and their relationship to you.
7. Explain the reason an agent is required and confirm if other family members know about the appointment.
8. Review Part 3, which outlines the obligations and responsibilities of an agent. Acknowledge your understanding of these responsibilities if you are the appointed agent.
9. In Part 4, the agent must declare that they have not faced bankruptcy or serious criminal charges relevant to their responsibilities. They should sign and date this section.
10. For payment options, complete either the financial institution section or post office section in Part 5.
11. If applicable, Part 6 requires a medical practitioner certificate to confirm the customer's inability to manage their financial affairs.
12. Finally, send the completed application form to the appropriate Social Welfare Office as listed in Part 7. Ensure all sections are fully completed before submission.

Complete your application form online today to ensure timely processing of your request.