FAA1.D Application Requirements : 05 Authorized Representatives - Overview
Authorized Representatives - Overview
 
(01/01/21 – 12/31/21)
 
This policy is effective for all applications received on or after 12/01/2021. For applications received before 12/01/2021 use the prior policy.
 
An authorized representative is a non-budgetary unit member chosen by the Primary Informant(g) to assist on their behalf in the application process. The assistance provided by the authorized representative may include, but is not limited to, the following:
 
Completing an application
Completing forms (work registration, when required)
Completing the interview
Reporting changes
Providing verification
Receiving notification
 
The Primary Informant (PI) is legally responsible for all statements and information provided on the application and stated at the interview by the authorized representative. A different authorized representative may be chosen for each program.
 
When the PI requests an authorized representative they must submit a written request on either of the following:
 
The Request for Authorized Representative (FAA-1493A) form.
The Request for Authorized Representative (C034) notice.
 
NOTE When the PI is applying for NA benefits, the authorized representative must answer whether they are currently disqualified from receiving NA due to an IPV. No response is required when the application is for CA only. See Authorized Representatives – NA for additional policy for NA Authorized Representatives.
 
When an eligibility decision is being appealed, the following actions occur concerning the authorized representative:
 
The authorized representative designated at the time of the action being appealed must be involved in any proceedings involving the same action.
A new authorized representative, when designated, may handle any future actions related to the program(s) for which the representative is the designee.
 
The authorized representative must meet all of the following requirements:
 
Be appointed in writing with a signature by the PI. The PI must provide a signature using an acceptable method to sign the document either written, electronic, or telephonic signature.
Be an adult non-budgetary unit member.
Be fully aware of the budgetary unit’s relevant household circumstances.
 
The following are types of representatives:
 
 
For information regarding an EBT Alternate Card Holder, see EBT Alternate Card Holder.
 
The authorized representative remains in effect until any of the following occur:
 
The PI requests, in writing, at any time to revoke their consent of the authorized representative. (See Revoking an Authorized Representative)
The authorized representative requests, in writing, to be removed from the case. The PI needs to select another authorized representative, when needed.
The application for assistance is withdrawn or denied.
The eligibility ends and there is a break in benefits.