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AUTHORIZED CONTACT REQUEST Complete this form if you want to allow Acumen Fiscal Agent (AFA) to speak about your account with anyone other than you, the employer. I, ___, (hereafter the Employer)

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How to fill out authorized contact request

01

Obtain the authorized contact request form from the respective organization or department.

02

Fill out your personal details including name, address, contact information, and any required identification.

03

Provide the details of the authorized party you wish to designate including their name, contact information, and relationship to you.

04

Sign and date the form to indicate your agreement to designate the authorized party.

05

Submit the completed form to the appropriate individual or department for processing.

Who needs authorized contact request?

01

Individuals who need to designate someone else to act on their behalf in specific matters or transactions.

02

Organizations or departments that require authorization from individuals to communicate or transact with designated parties.

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What is authorized contact request?

Authorized contact request is a formal request to designate an individual or entity as the authorized point of contact for a particular matter or account.

Who is required to file authorized contact request?

Any individual or entity who wants to designate someone as the authorized contact for a specific purpose must file an authorized contact request.

How to fill out authorized contact request?

To fill out an authorized contact request, one must provide the necessary information about the designated contact person or entity, including their name, contact details, and the specific purpose for which they are being authorized.

What is the purpose of authorized contact request?

The purpose of an authorized contact request is to ensure that there is a designated point of contact who has the authority to represent or act on behalf of the individual or entity in a particular matter.

What information must be reported on authorized contact request?

The authorized contact request must include the name, contact information, and the specific purpose for which the individual or entity is being designated as the authorized contact.

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