I authorize the person or firm below to act as my representative and to sign my name to any forms 2025

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Authorized employer representative means an individual who has been delegated the authority to act on behalf of an ASRS employer to provide the ASRS with information.
A Personal Representative is defined under state law and has authority to act as the patient. Personal Representatives can sign forms on behalf of the patient and authorize treatment.
It does allow the Authorized Representative to have access to your PHI. Who can act on my behalf to make health care decisions? A Personal Representative who has been granted legal authority to act on behalf of you. A Personal Representative will be able to make health care decisions regarding a members dental care.
Authorised Representative a person or organisation that has written permission to act for and on behalf of the Responsible Supplier. NOTE: The Authorised Representative may be a facilitator, consultant, agent or a Certifier.
An Authorized Representative is an individual with legal authority to bind the government entity (e.g., the Chief Executive Officer of the government entity).
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Authorized representative means: An executive officer of a corporation. A general partner of a partnership. The proprietor of a proprietorship.
Someone who you choose to act on your behalf with the Marketplace, like a family member or other trusted person. Some authorized representatives may have legal authority to act on your behalf.
Authorized Representative of the Company means such person or persons as may be designated to act on behalf of the Company by certificate signed by the secretary of the board of directors of the Company and filed with the Issuer and the Trustee.

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