How to use or fill out DHS Instructions Authorization with our platform
- Click ‘Get Form’ to open the DHS 1123 authorization form in the editor.
- In the first field, enter the full name of the person authorizing the disclosure.
- If applicable, describe the type of legal appointment for legal representatives and attach any necessary documentation.
- Check the appropriate boxes for requested information. If selecting 'Other', provide specific details and service dates.
- If different from step 1, enter the applicant’s or beneficiary’s name.
- Input the applicant’s or beneficiary’s Social Security Number and/or Date of Birth.
- Enter the name of the person or agency authorized to receive this information.
- Specify the relationship of that person or agency to the applicant/beneficiary, if any.
- Provide the mailing address and phone number of the authorized recipient.
- Explain how this information will be used by the authorized recipient; note that this is optional for self-releases.
- Indicate a date or event that will end this authorization; if left blank, it defaults to one year from today.
- Finally, have the authorizing individual sign and date the form, including their mailing address.
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| 2013 | 4.8 Satisfied (42 Votes) |
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