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The purpose of this Informational Letter (INF) is to introduce LDSS-4942: "Food Stamp Program Authorized Representative Request Form" (3/09). This form (available in English and Spanish) was developed for use with the electronic food stamp application for those households wishing to designate an authorized representative. This form is also available for statewide use and may be used by any food stamp applicant/recipient to designate an authorized representative.
It is recommended, but not required, that all applicants/recipients use this form when designating an authorized representative for purposes of applying for or accessing their food stamp benefit. However, all authorized representatives must be authorized in writing by the applicant/recipient or other responsible adult member of the household.
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