Signing the Application and Other Documents
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This section includes the ways that a participant can sign the application and other documents.
Policy
In order to complete the eligibility determination for any program, an official application is required to be signed and dated by the PI(g), an adult participant, or an authorized representative under penalty of perjury. This is completed on the application signature page.
A signed application is required for any of the following:
●When submitting a new or renewal application. (See Application Requirements for more information about identifiable applications.)
●When requesting additional program benefits at the time of interview.
A signature is a name or mark representing the name of the participant or authorized representative. The signature is personally added to authenticate the participant or authorized representative as the source or approval of the information.
A signature is unique to the participant or authorized representative signing the document. When available, all of the following are acceptable methods to sign a document, which becomes their legal signature:
●Written Signature
A hand-written signature or mark of a participant’s name or authorized representative on paper documents as proof of identity. The purpose of the signature is also to indicate the participant’s agreement with the information on the document.
NOTE The signature entered on page 1 of the Application for Benefits (FAA-0001A) is only for identifiable application purposes. This signature allows FAA to accept an incomplete application and save the date it is received and signed as the date of application. The participant or authorized representative is required to sign under penalty of perjury the last page of the application before a determination can be completed.
When the participant or authorized representative signs the application with a mark, the signing is to be witnessed by FAA staff. The witness is required to sign the application in the space designated for the witness.
When the participant is not able to read or write, or is physically unable to do so, the representative may sign the paper application. Documentation needs to support the reason that the participant is unable to sign the application.
●Electronic Signature
A participant or an authorized representative can electronically sign the application using the electronic signature option through Health-e-Arizona (HEAplus). An HEAplus account is required to use this signature method.
The participant enters their name and checks the box at the end of their application.
●PIN Signature via Text Message or Email
FAA staff can request for a personal identification number (PIN) to be sent to the participant or authorized representative via text message or email. Assistance from FAA staff is required for signatures to be obtained via text message or email.
When the PIN is received by the participant or authorized representative, all of the following apply:
●The participant or authorized representative is required to share the PIN with FAA staff over the phone or in person.
●When FAA staff enter the PIN into HEAplus within the allotted timeframe of 10 minutes, HEAplus completes the signature process electronically. When the process is not completed within the timeframe a new PIN needs to be requested or another signature option can be used.
●Recorded Telephonic Signature
A recorded telephonic signature, or voice signature, is a voice recording intended to capture the voice authorization of the participant or authorized representative acknowledging they gave the information, answered the questions truthfully, understood, and agreed to the information in the document that is being signed. After recording a summary of the budgetary unit’s details, the participant or authorized representative is asked for specific information that equals the voice signature.
NOTE A voice signature that is provided on behalf of a participant or an authorized representative by an American Sign Language interpreter is a valid recorded telephonic signature.
Identity is verified before the recorded telephonic signature by requesting the participant or authorized representative provide confidential case information.
Responses provided by the participant or authorized representative are recorded by designated staff.
●Signature Pad
A signature pad is a device that electronically captures a participant’s or authorized representative’s handwritten signature on a liquid-crystal display (LCD) touchpad using a pen-type stylus.
Procedures
Designated staff includes the FAA Customer Care Centers and Processing Centers, HEAplus Customer Support, Contracted Third-Party Non-Merit Staff(g), AHCCCS staff, and Community Assistors. The recordings must be readily accessible to FAA.
The signature pad automatically transmits the captured signature directly to an OnBase(g) Unity Form(g).
The signature pad eliminates the manual process of printing, signing, scanning, and uploading a document to OnBase.
FAA staff are to use a signature pad when available in an FAA office.
When using a signature pad, validate the factor in HEAplus as visually viewed.
Documentation in case notes must include, that the signature was visually viewed, the date the signature was transmitted to OnBase, and the document handle reference number.
When a request for a signature from a required participant is not provided, the application can be denied with NS (No Signature). Documentation must support the reason an application is denied.
Verification
Identity is verified before the recorded telephonic signature by requesting the participant or authorized representative provide confidential case information.
Legal Authorities
7 CFR 273.2(c)(7)(iii)
7 CFR 273.2(c)(7)(iii)(A)
7 CFR 273.2(c)(7)(vii)
AAC R6-12-201
AAC R6-12-203
AAC R6-12-205
AAC R6-12-302
Food and Nutrition Service (FNS) Waiver
last revised 03/04/2024