Get Long-term Disability Authorization Of Personal Representative

Filling out the Long-term Disability Authorization of Personal Representative is an important step in managing your disability claim. This guide provides a clear, step-by-step walkthrough to help you complete the form accurately online.

Follow the steps to effectively complete the form online.

1. Click ‘Get Form’ button to access the Long-term Disability Authorization of Personal Representative and open it in your editor.
2. In the first blank space, enter your full name. This identifies you as the individual authorizing a personal representative for your claim.
3. In the second blank space, enter the full name of the person you wish to designate as your Authorized Personal Representative. This individual will have access to your claim information.
4. Review the paragraph regarding the understanding of information access, ensuring you understand what information will be disclosed and agree to the terms outlined.
5. In the section labeled ‘Personal Representative’s Full Name,’ enter the full name of your designated representative again for confirmation.
6. Have your personal representative sign the designated area. This confirms their acceptance of the role.
7. Enter the date the form is being completed. This is crucial for record-keeping purposes.
8. Provide your personal representative’s telephone number, address, city, state, and zip code. This information is needed for communication purposes.
9. Once all fields are filled out correctly, review your inputs for accuracy. After verifying, you may save your changes, download, print, or share the completed form.

Take the next step and complete your Long-term Disability Authorization of Personal Representative form online today.