Authorized / personal representative. The Authorized Representative will have the legal authority to assist / represent the individual with any and all matters relating to the individual s application with the Department. GENERAL INSTRUCTIONS: 1. The completion of the DHS 1121 is self-explanatory. All sections of the form DHS 1121 shall be completed. Any changes made to the form will invalidate the form. 2. The designation of the authorized representative may be revoked at any time requesting.
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How to fill out the HI DHS 1121 Instructions online
Filling out the HI DHS 1121 form is an important step in designating an authorized representative to assist with your application. This guide will provide you with detailed, step-by-step instructions for completing the form online, ensuring a smooth and efficient process.
Follow the steps to successfully complete the HI DHS 1121 form online.
- Press the ‘Get Form’ button to obtain the form and open it for editing.
- Complete all sections of the HI DHS 1121 form. Ensure that you provide accurate information in each field as any alterations may invalidate the submission.
- Designate your authorized representative by filling out their information in the designated section. Remember, this individual can assist you with all matters related to your application.
- If you need to revoke the authorization for your representative, indicate your intention in writing or by completing another HI DHS 1121 form.
- Ensure that you and your authorized representative sign and date the form where required.
- Upon completion, save any changes made to the form, and then choose to download, print, or share the document as needed.
Now that you are equipped with the necessary steps, complete the HI DHS 1121 form online today!
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