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Get NH DFA Form 778 2017-2024

R) to help you apply for or get benefits. You must fill out this form for every AR you choose. An AR is a friend, family member, other adult, or an agency that has a concern for your wellbeing. You must choose your own AR. Your AR must agree to help you. DHHS will talk to your AR until you or your AR tells us otherwise. AUTHORIZED REPRESENTATIVE DUTIES Please check off the things that you want your AR to do for you: Get, fill out, and sign applications, forms, and other DHHS paperwork for me. Ge.

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