Get Au Mo050 2018-2026

The AU MO050 form allows individuals to authorize another person to act on their behalf for Medicare services when they are unable to manage their own affairs due to a medical condition. This guide will provide detailed, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to fill out the AU MO050 form online.

1. Click the 'Get Form' button to obtain the AU MO050 form and open it in your document editor.
2. Fill in the Medicare customer’s details. Enter their Medicare card number, full name, gender, date of birth, and permanent address, ensuring all fields are completed clearly and accurately.
3. Complete the authorized representative's details. Provide your title (Mr, Mrs, Miss, Ms, Other), full name, date of birth, relationship to the Medicare customer, and both permanent and postal addresses.
4. Sign and date the form in the designated area, confirming your acceptance of the responsibilities and obligations that come with this authorization.
5. Attach all required documents. Ensure you have originals or certified copies of identification, a statutory declaration of your relationship, evidence of similar arrangements, and proof of the customer’s inability to manage their own affairs.
6. Review the completed form to ensure all required questions are answered and that signatures are in place.
7. Return your completed form and all required documents either in person to a service center or by post to the Department of Human Services at the specified address.
8. After submission, keep a copy of the form and documents for your records.

Begin the process of completing your AU MO050 form online today!