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Instructions for Form DHS1121A Agreement to Act as an Authorized Representative - Hawaii
This document contains official instructions for Form DHS1121A , Agreement to Act as an Authorized Representative - a form released and collected by the Hawaii Department of Human Services. An up-to-date fillable Form DHS1121A is available for download through this link.
FAQ
Q: What is Form DHS1121A?A: Form DHS1121A is the Agreement to Act as an Authorized Representative specific to Hawaii.
Q: Who should use Form DHS1121A?A: Form DHS1121A should be used by individuals who want to act as authorized representatives for someone applying for benefits in Hawaii.
Q: What is the purpose of Form DHS1121A?A: The purpose of Form DHS1121A is to establish an agreement between the applicant and their authorized representative regarding the representation.
Q: Are there any fees associated with submitting Form DHS1121A?A: No, there are no fees associated with submitting Form DHS1121A.
Q: What information do I need to provide on Form DHS1121A?A: You need to provide your personal information, including your name, address, and contact details, as well as the applicant's information and a declaration of your responsibilities as an authorized representative.
Q: Can I appoint more than one authorized representative?A: Yes, you can appoint more than one authorized representative, but each representative must fill out a separate Form DHS1121A.
Q: What should I do with the completed Form DHS1121A?A: You should submit the completed Form DHS1121A to the appropriate DHS office in Hawaii.
Q: Can the authorized representative make decisions on behalf of the applicant?A: Yes, the authorized representative has the authority to make decisions on behalf of the applicant, as specified in the agreement.
Q: How long does it take to process Form DHS1121A?A: The processing time for Form DHS1121A may vary, but you will be notified of the decision within a reasonable timeframe.
Instruction Details:
- This 1-page document is available for download in PDF;
- Actual and applicable for the current year;
- Complete, printable, and free.
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