Member authorization 2026

1. Click ‘Get Form’ to open the Member Authorization Form in the editor.
2. In Part A, enter your last name, first name, and middle initial. Then, provide your date of birth in the format mm/dd/yyyy.
3. Fill in your full street address, including city, state, and ZIP code. Next, provide your daytime phone number and cell/mobile number.
4. Locate your identification number and group number from your member identification card and enter them in the respective fields.
5. In Part B, specify the full name of the person or company who will receive your information. Avoid using general terms.
6. For Part C, choose whether to release all information or limited information by checking the appropriate boxes based on what applies to you.
7. Complete Parts D and E by indicating the purpose of approval and selecting an expiration date for this authorization.
8. Finally, sign and date the form in Part F. Ensure that your signature matches the name provided in Part A.

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