- TO:
- ALL FAMILY SUPPORT DIVISION OFFICES
- FROM:
- ALYSON CAMPBELL, DIRECTOR
- SUBJECT:
- AUTHORIZED REPRESENTATIVE FORMS (FS-6ARI AND FS-6ARF)
- FORMS MANUAL REVISION #8
DISCUSSION:
The purpose of this memo is to introduce new Authorized Representative forms, FS- 6ARI and FS-6ARF. The FS-6ARI will be used when an individual is appointed as an Authorized Representative. The FS-6ARF will be used when a facility is appointed as an Authorized Representative. These forms will only be used for the Food Stamp program.
NOTE: When a customer using an Individualized Supported Living (ISL) service applies for Food Stamps and wants to appoint the provider as an authorized representative, FS-6ARI will be used. However, when an individual applies for Food Stamps and wants to appoint a Group Home Service as their authorized representative, FS-6ARF will be utilized.
The IM-6AR will no longer be used effective April 30, 2015.
Please print these new forms from the Family Support Division intranet until forms can be ordered from the warehouse.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
AC/mw