Form IL444-2998 Approved Representative Consent Form - Illinois

Form IL444-2998 Approved Representative Consent Form - Illinois

What Is Form IL444-2998?

This is a legal form that was released by the Illinois Department of Human Services - a government authority operating within Illinois. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form IL444-2998?
A: Form IL444-2998 is the Approved Representative Consent Form specific to Illinois.

Q: What is the purpose of Form IL444-2998?
A: The purpose of Form IL444-2998 is to authorize a representative to act on behalf of an individual in matters related to healthcare benefits.

Q: Who needs to complete Form IL444-2998?
A: Form IL444-2998 needs to be completed by individuals who want to designate a representative to handle their healthcare benefits in Illinois.

Q: Is there a fee for submitting Form IL444-2998?
A: No, there is no fee for submitting Form IL444-2998.

Q: What information do I need to provide on Form IL444-2998?
A: You will need to provide your personal information, including your name, address, Social Security number, and the name of your chosen representative.

Q: Can I revoke or change my representative after submitting Form IL444-2998?
A: Yes, you can revoke or change your representative by submitting a new Form IL444-2998 to the Illinois Department of Human Services.

Q: How long does it take to process Form IL444-2998?
A: The processing time for Form IL444-2998 may vary, but it usually takes a few weeks to receive a decision from the Illinois Department of Human Services.

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Form Details:

  • Released on September 1, 1999;
  • The latest edition provided by the Illinois Department of Human Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form IL444-2998 by clicking the link below or browse more documents and templates provided by the Illinois Department of Human Services.

Download Form IL444-2998 Approved Representative Consent Form - Illinois

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