Get Acc5937 Authority To Act Form. Acc5937 Authority To Act Form

The ACC5937 Authority To Act Form is a crucial document that allows you to authorize someone to act on your behalf. This guide provides step-by-step instructions to help you complete the form accurately and efficiently, ensuring your selected representative can assist you with your claims.

Follow the steps to fill out the ACC5937 Authority To Act Form online.

1. Click the ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. In the 'Your details' section, enter your full name, claim number, date of birth, email address, and complete your address along with your home, mobile, and work phone numbers.
3. In the 'Your nominated person' section, provide the full name, relationship to you, date of birth, email address (if applicable), postal address, and business address (if applicable) of the person you are authorizing.
4. Indicate where you would like to receive correspondence by selecting the appropriate preference. Additionally, fill in the home, mobile, and work phone numbers of your nominated person.
5. In the 'Authority to act' section, select whether this authority covers specific claims or all claims currently managed by ACC. If applicable, list the claim number(s) for the specific claims.
6. Review the 'Declaration' section where you consent to the terms. Ensure you understand the implications of granting authority to your nominated person.
7. Sign the form and add the date of signing.
8. After completing the form, save your changes or download it. You can print or share the form as necessary.

Act now to complete your ACC5937 Authority To Act Form online and ensure your representation is authorized.