Get the free FDPIR Proxy Designation Form

Proxy Designation Form to be copied onto Tribal Letterhead and emailed to the USDA FNS Point of Contact no later than March 14, 2024Ms. Keri BradfordGomez Food and Nutrition Service U.S. Department

How to fill out fdpir proxy designation form

How to fill out fdpir proxy designation form

1. Step 1: Obtain a copy of the FDPIR proxy designation form.
2. Step 2: Fill in your personal information including your name, address, and contact information.
3. Step 3: Indicate the details of the person you are designating as your proxy including their name, address, and contact information.
4. Step 4: Sign and date the form to make it legally binding.
5. Step 5: Submit the completed form to the appropriate FDPIR office or agency.

Who needs fdpir proxy designation form?

1. Individuals who are unable to personally pick up their FDPIR food assistance and wish to designate someone else to do so on their behalf.

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What is fdpir proxy designation form?

The FDPIR Proxy Designation Form is a document used by participants in the Food Distribution Program on Indian Reservations (FDPIR) to designate a proxy who can act on their behalf in matters related to the program.

Who is required to file fdpir proxy designation form?

Individuals who participate in the FDPIR and wish to designate someone else to handle their benefits or participate on their behalf are required to file the FDPIR Proxy Designation Form.

How to fill out fdpir proxy designation form?

To fill out the FDPIR Proxy Designation Form, an eligible participant must provide their personal information, the details of the proxy they wish to designate, and any required signatures or dates to validate the designation.

What is the purpose of fdpir proxy designation form?

The purpose of the FDPIR Proxy Designation Form is to ensure that participants can authorize someone they trust to manage their benefits and carry out necessary transactions on their behalf.

What information must be reported on fdpir proxy designation form?

The form requires the participant's name, address, and signature, as well as the proxy's name, address, relationship to the participant, and signature.