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The authorized representative is your Power of attorney Parent Court-appointed guardian give end date Other tell us about your relationship 3. How long will this person be able to act for you Give end date mm/dd/yy / 4. I would like the person acting for me to be able to do the following check all that apply Fill out an application form* Check the status of Medicaid application or renewals. Fill out renewal form* Give the state all forms and facts that are needed to get benefits. Report changes ...

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2015	4.8 Satisfied (258 Votes)
2011	4.3 Satisfied (363 Votes)

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What is H1003 form?

Form H1003, Appointment of an Authorized Representative | Texas Health and Human Services.

Who is the authorized representative?

An authorized representative is an individual authorized under State or other applicable law to act on behalf of a beneficiary or other party involved in the appeal. Authorized representatives have all of the rights and responsibilities of a beneficiary or party, as applicable, throughout the appeals process.

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