Form H1003 Appointment of an Authorized Representative to Allow Another Person to Act for You - Texas

Form H1003 instructions

An H1003 Form is applicable for those situations when an individual would like to give another person the right to act on their behalf in their relations with the HHS. Along with the form, the individual who completed the form is addressed as The Client or The Applicant, while the appointed person is addressed as The Authorized Representative. The document consists of several parts, which include the following:

1. Contact Details . In the first part of the form, the applicant is required to state their name and their case number. They must also state information about their authorized representative, including their name, address, and telephone number.
2. The Representative . Here the applicant must designate whether the representative is authorized by a power of attorney, appointed by a court, or authorized in any other way.
3. Signature and Date . At the end of the document, both parties must put their signatures and dates when they have signed it.

The form also contains other parts, where the individual is provided with information about how to change their appointed representative, which rights they have, and in what kind of situations they are legally authorized to perform.