Get the free Support Broker Agreement - OPWDD

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Memorandum of Understanding for the Provision of: Fiscal Intermediary Services This memorandum of understanding (YOU) is an agreement between, Redirection (SD) Participant/Designee and Fiscal Intermediary

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How to fill out support broker agreement

01

Start by obtaining a support broker agreement form from the relevant authority or department.

02

Read the entire agreement carefully to understand its terms and conditions.

03

Fill in your personal details, such as your name, address, and contact information, in the designated sections of the agreement.

04

Provide a detailed description of the support brokerage services you will be providing.

05

Specify the duration of the agreement, including the start and end dates.

06

Include any additional terms or conditions that are relevant to your specific agreement.

07

Review the filled-out agreement to ensure accuracy and completeness.

08

Sign and date the agreement, and have the other party or parties involved do the same.

09

Make copies of the signed agreement for all parties involved.

10

Submit the original signed agreement to the appropriate authority or department, as instructed.

Who needs support broker agreement?

01

Support broker agreements are typically needed by individuals or organizations who offer support brokerage services.

02

These may include independent support brokers, support broker agencies, or other entities involved in connecting individuals with support services.

03

Support broker agreements help establish the rights and responsibilities of both the support broker and the party receiving support.

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What is support broker agreement?

A support broker agreement is a legal document outlining the relationship and responsibilities between a support broker and an individual receiving services. It details the services provided, the expectations of both parties, and the terms of compensation.

Who is required to file support broker agreement?

Individuals receiving certain support services, their families, or guardians who utilize the services of a support broker are typically required to file a support broker agreement.

How to fill out support broker agreement?

To fill out a support broker agreement, individuals should provide their personal information, details about the services requested, the support broker's information, and clearly define the terms and conditions of the agreement. Both parties must then sign the document.

What is the purpose of support broker agreement?

The purpose of a support broker agreement is to establish clear expectations and responsibilities, protect the rights of the individual receiving services, and ensure that the support broker can deliver services effectively and ethically.

What information must be reported on support broker agreement?

The support broker agreement must include the names and contact information of both the individual and the broker, the specific services to be provided, the duration of the agreement, compensation details, and any other relevant terms.

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