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DISUSED 58A Rev. 09/2019State of Utah Department of Workforce Services CONFIRMATION OF EXTENDED SERVICES Funding be completed by the Extended Services (ES) representative. This form confirms that
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To fill out form POA - department, follow the steps below:
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Obtain the form from the department or download it from the official website.
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Start by entering your personal information such as your name, address, and contact details.
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Make sure to provide accurate information and double-check for any errors.
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Indicate the specific department or division you are authorizing.
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Clearly state the purpose or reason for authorizing the department.
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If required, have the form notarized or witnessed by an authorized person.
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Submit the completed form to the designated department or follow the submission instructions provided.

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- Granting a department the authority to make decisions or take actions on behalf of an individual or organization.
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It is recommended to consult the specific requirements or guidelines provided by the department or organization to determine if form POA - department is necessary.
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Form POA - Department is a Power of Attorney form that grants authority to an individual or entity to act on behalf of another person in dealings with a department.
Individuals or entities that wish to authorize another person to act in their stead for department-related matters are required to file Form POA - Department.
To fill out Form POA - Department, provide the necessary personal details of both the principal and the agent, specify the exact powers granted, and ensure the form is signed and dated by all parties involved.
The purpose of Form POA - Department is to legally authorize someone to make decisions and take actions on behalf of the principal with respect to departmental affairs.
Form POA - Department typically requires names, addresses, the specific powers granted, and identification information of both the principal and the agent.
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