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State of Illinois
Department of Human ServicesAUTHORIZATION TO ACT AS PAYEEIndividual\'s Identification/Account Number
I hereby authorize the facility director of
on behalf of
(Name of Individual)
to
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What is authorization to act as?
It is a legal document that grants permission for someone to act on behalf of another individual or organization.
Who is required to file authorization to act as?
Any individual or organization who needs someone to act on their behalf.
How to fill out authorization to act as?
The authorization form is usually filled out with the relevant personal or organizational information, signed, and submitted to the appropriate authority.
What is the purpose of authorization to act as?
The purpose is to legally grant permission for someone to act on behalf of another individual or organization.
What information must be reported on authorization to act as?
The form typically includes the name of the person or organization giving authorization, the name of the person or organization being authorized, and the scope of the authorization.
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