Food stamp authorized representative form 2026

1. Click ‘Get Form’ to open it in the editor.
2. In Section 1, indicate if you want someone to act on your behalf. Select the functions that your representative will perform, such as applying for benefits or ongoing assistance. Remember, one form is needed per representative.
3. Proceed to Section 2 and clearly print the name of your representative. Choose their association with you from the provided options, such as 'Friend' or 'Attorney'. Fill in their mailing address accurately.
4. Select the specific functions your authorized representative will undertake. Ensure you check all relevant boxes for both application and ongoing assistance.
5. If applicable, provide the date of birth and Social Security Number for EBT access. Both you and your representative must sign and date the form in the designated areas.
6. Finally, review all information for accuracy before submitting. If any changes are needed later, remember that you can revoke this authorization at any time.

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