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An applicant and or recipient may appoint or designate an individual or organization to serve as an Authorized Representative on their behalf. The individual or organization may assist with the application and/or renewal process and receive copies of notices for SNAP, cash and medical assistance.
An Authorized Representative (AR) must be knowledgeable of the individual’s circumstances. AR responsibilities include, but are not limited to: knowledge of income and resources and household composition and tax relationships.
Authorized representatives also assume responsibility for the accuracy of the information provided to the Division of Family Resources for applicants and must maintain confidentiality of all information provided.
Authorized representative forms are available on the HIP website http://www.in.gov/fssa/hip/2509.htm
The Authorized Representative form can also be generated from the following locations:
Each bar coded AR form is unique to a specific case, and copies should not be made of the form to attach to other cases, nor should the bar code be altered under any circumstances. The bar coded forms are unique to each case. This facilitates the attachment of the form to the appropriate case for expedient processing and provides better service to the AR and to the client.
During form completion, the Authorized Representative and the individual will determine their specific functions, which are either apply or ongoing.
Apply functions include:
Ongoing functions include:
EBT (SNAP and TANF only) functions include: