Authorized Representatives
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An authorized representative is a non-budgetary unit member chosen by the Primary Informant (PI) to assist on their behalf in the application process.
Policy
The primary informant(g) can appoint an authorized representative. An authorized representative chosen by the Primary Informant (PI) to assist on their behalf may provide assistance with any of the following:
●Completing an application
●Completing forms (work registration, when required)
●Completing the interview
●Providing verification
●Receiving notification
●Reporting changes
NOTE See EBT Alternate Cardholder for more information regarding an Electronic Benefit Transfer (EBT) Alternate Cardholder.
When the PI requests an authorized representative, they need to submit a written request using any of the following:
●Application for Benefits (FAA-0001A) form
●OnBase Authorized Representative Request Unity form
NOTE Completion of a Unity form is done with the assistance of FAA staff. To complete and sign a Unity form, contact FAA by one of the following ways:
●Telephone. (See Customer Care Center for contact information and hours.)
●In person at any FAA office. (See the DES Office Locator webpage found at https://des.az.gov/find-your-local-office and click ‘Find a DES Office’ to locate the nearest FAA office.)
●Authorized Representative Request (FAA-1493A) form
●Authorized Representative (DE-112) form in the HEAplus
●Nutrition Assistance (NA) Authorized Representative Request (FAA-1826A) form
●Request for Authorized Representative (C034) notice
NOTE When the only adult participant in the budgetary unit(g) has a court-appointed legal guardian, the legal guardian is the only person required to sign the form to request an authorized representative. The signature of the PI is not required.
When the PI is residing in an authorized drug and alcohol treatment center (DAATC), the PI is required to appoint the center’s NA representative as their authorized representative to continue receiving NA benefits while in treatment. See Residents of Institutions for NA for more information about the DAATC authorized representative requirement.
A different authorized representative may be chosen for each program. See all of the following for additional information and policies:
Authorized Representative’s Rights and Responsibilities
When an authorized representative is appointed, FAA ensures both the PI and the authorized representative are informed of their rights and responsibilities.
The authorized representative is required to meet all of the following requirements:
●Appointed in writing with a signature by the PI.
NOTE The PI and authorized representative are required to provide a written, electronic, or recorded telephonic signature. The signature of the PI is not required when they have a legal guardian. See Signing the Application and Other Documents for acceptable methods to sign the application or other documents.
●An adult non-budgetary unit member.
●Fully aware of the budgetary unit’s relevant household circumstances.
●Attest to whether they are currently disqualified from receiving NA due to an intentional program violation(g).
The authorized representative remains in effect until one of the following occurs:
●The PI submits a request, at any time to revoke their consent of the authorized representative by submitting one of the following:
Authorized Representative Removal (FAA-1494A) form.
Written or verbal statement from the participant.
NOTE See Revoking an Authorized Representative for information on removing an authorized representative.
●The authorized representative requests, in writing, to be removed from the case. The PI can select another authorized representative when necessary.
●The application for assistance is withdrawn or denied. The authorized representative is still required to participate in an appeal.
●The eligibility ends and there is a break in benefits.
●The PI is no longer residing at an authorized drug and alcohol treatment center (DAATC).
●The authorized DAATC NA representative is no longer an employee of the DAATC.
When an eligibility decision is being appealed, all of the following apply regarding the authorized representative:
●The authorized representative designated at the time of the action being appealed is required to be involved in any proceedings involving the same action.
●A new authorized representative, when designated, may handle any future actions related to the programs for which the representative is the designee.
The PI is responsible for all of the following:
●The accuracy of all information provided by the authorized representative. This includes information written on the application and stated during interviews.
NOTE The authorized representative can be held personally liable when a court determines that they are responsible for causing the budgetary unit an overpayment.
●Making sure their authorized representative is providing accurate information and is maintaining awareness of the budgetary unit’s circumstances.
●Providing updated authorized representative information to FAA each time the budgetary unit renews benefits.
An authorized representative found responsible for providing false or fraudulent information or committing an intentional program violation (IPV) is subject to all of the following:
●Disqualifications
●Jail sentences
●Monetary fines
●Repayment of inappropriately obtained benefits
The authorized representative is responsible for all of the following:
●Assisting the budgetary unit with completing applications and forms.
●Assisting the budgetary unit with reporting changes and getting any required verification regarding the change.
●Attending interviews for the budgetary unit, when needed. These interviews may be in person or over the phone. See NA authorized representative and CA authorized representative for more information on program specific requirements.
●Maintaining awareness of the budgetary unit’s circumstances.
●Providing accurate information to FAA.
●Providing verification requested by FAA during the application process.
NOTE The authorized DAATC NA representative is required to sign the application and conduct all interviews on behalf of the DAATC residents.
●Providing their own updated information to FAA each time they help the budgetary unit renew benefits.
NOTE The appointed authorized representative is required to confirm that they agree to being the authorized representative and for NA, that they are not disqualified for an IPV.
The PI and the NA authorized representative must be informed about the rules and penalties regarding the IPV. The Authorized Representative Request (FAA-1493A) form and the Nutrition Assistance (NA) Authorized Representative Request (FAA-1826A) form are available in the Documents Center on the DES internet website.
The authorized representative has the right to review the case file(g) and obtain information from it at any time. See Right to Confidential Case Information for information about who can review case information.
Authorized Representative of Multiple Cases
An NA or CA authorized representative may represent no more than three budgetary units at a time.
NOTE The three budgetary unit limit does not apply when the authorized representative is an employee designated to act on behalf of the participant by any of the following organizations:
●An authorized drug and alcohol treatment center (DAATC)
●A Refugee Resettlement Program (RRP) Voluntary Agency (VOLAG)
●A Welcome Corps (WC) sponsor group
When the NA or CA authorized representative has access to multiple cases, FAA ensures all of the following:
●The PI freely requests the help of the authorized representative.
●The budgetary unit is being represented correctly.
●The budgetary unit is receiving the correct amount of benefits.
An NA or CA authorized representative may be needed for any of the following reasons:
●As a precaution in the event the participant has an emergency.
●The participant has been assigned a legal guardian.
●The participant has difficulty completing the application process.
The PI and the authorized representative are required to be aware of their rights and responsibilities. See Authorized Representatives – Rights and Responsibilities for additional information.
Authorized Representatives NA
An NA authorized representative cannot be any of the following:
●A provider of prepared meals for the homeless(g) when they are representing a homeless participant.
●A retailer involved in the acceptance of NA.
●A state agency employee involved in the issuance of NA, unless authorized in writing by the Region Program Manager (RPM).
●Someone disqualified from receiving NA for an IPV during their disqualification period.
NOTE When no one else is available to act as an authorized representative, the person serving an lPV disqualification may act as the authorized representative. This is required to be attested to by the PI on one of the following:
●Application for Benefits (FAA-0001A) form.
●Authorized Representative Request (FAA-1493A) form.
●Authorized Representative (DE-112) form in the HEAplus.
●Nutrition Assistance (NA) Authorized Representative Request (FAA-1826A) form.
●OnBase Authorized Representative Request Unity form with assistance from FAA staff.
●Request for Authorized Representative (C034) notice.
The PI is not required to be present at the NA interview when the NA authorized representative conducts the interview on behalf of the PI.
The person designated to act as the NA authorized representative is required to take all of the following actions:
●Complete the authorized representative section on the C034 notice or one of the following forms:
FAA-0001A
FAA-1493A
FAA-1826ª
DE-112 form in HEAplus
Authorized Representative Request OnBase Unity form.
NOTE Completion of a Unity form requires assistance from FAA staff. To complete and sign a Unity form, contact FAA by one of the following ways:
●Telephone (See Customer Care Center for contact information and hours.)
●In person at any FAA office (See the DES Office Locator webpage found at https://des.az.gov/find-your-local-office and click ‘Find a DES Office’ to locate the nearest FAA office.)
●Check the appropriate box to indicate whether they are currently serving an NA disqualification due to an IPV.
●Sign the form in the designated area.
NOTE When the PI has attested in writing that the person being requested is the only one available to serve as the NA authorized representative, then the authorized representative is not required to provide their date of birth.
The PI or authorized representative can authorize an EBT Alternate Cardholder by completing the Designation of EBT Alternate Cardholder (FAA-1004A) form. See Electronic Benefit Transfer (EBT) QUEST Card for more information.
Authorized Representative CA
A CA authorized representative may be needed for any of the following reasons:
●As a precaution in the event the participant has an emergency.
●The participant has been assigned a legal guardian.
●The participant has difficulty completing the application process.
The PI is required to be present at the CA interview when the CA authorized representative conducts the interview on behalf of the PI.
When an alternate cardholder is required for the PI, see Reasons to Assign a CA EBT Alternate Cardholder and CA EBT Alternate Cardholder Emergency Situations for more information on CA EBT alternate cardholders.
The PI and the authorized representative must be aware of their rights and responsibilities. See Authorized Representatives – Rights and Responsibilities for more information.
Revoking an Authorized Representative
The PI may revoke the authorization, at any time. Any request submitted from the PI is acceptable when they are revoking an authorized representative. The use of the FAA-1494A form is optional.
When an eligibility decision is being appealed, all of the following apply concerning the authorized representative:
●The authorized representative designated at the time of the action being appealed is required to be involved in any proceedings involving the same action.
●A new authorized representative, when designated, may handle any future actions related to the program for which the representative is the designee.
Verification
The participant has the primary responsibility for providing verification. (See Participant Responsibilities – Providing Verification for additional policy.)
System interface that FAA has with other agencies for verification purposes may be used by FAA for some information.
NOTE System interface cannot verify every situation.
Examples of verification for legal guardianship include any of the following documents:
●Court Order
●Letter of Acceptance of legal guardianship
NOTE A petition cannot be used as verification.
Legal Authorities
7 CFR 273.2(n)
7 CFR 273.2(n)(1)
7 CFR 273.2(n)(1)(i)
7 CFR 273.2(n)(1)(i)(ii)
7 CFR 273.2(n)(2-3)
7 CFR 273.2(n)(4)(i)(A-D)
7 CFR 273.2(n)(3)
7 CFR 273.2(n)(4)(i)
7 CFR 273.2(n)(4)(D)(2)
last revised 10/27/2025 effective 09/02/2025