Examples of Delegated Official in a sentence
The UNIVEN Delegated Official will inform the Service Provider of any restrictions or areas requiring special scheduling.
Any restrictions associated with these special areas will be explained by the UNIVEN Delegated Official.
Delegated Official First NameMiddle InitialLast NameSuffix (e.g., Jr., Sr.)Delegated Official Signature (First, Middle, Last Name, Jr., Sr., M.D., D.O., etc.)Date Signed (mm/dd/yyyy) Check here if Delegated Official is a W-2 EmployeeTelephone NumberAuthorized Official Signature Assigning this Delegation(First, Middle, Last Name, Jr., Sr., M.D., D.O., etc.)Date Signed (mm/dd/yyyy)This section lists the documents that, if applicable, must be submitted with this completed enrollment application.
Delegated Official First NameMiddle InitialLast NameSuffix (e.g., Jr., Sr.)Delegated Official Signature (First, Middle, Last Name, Jr., Sr., M.D., D.O., etc.)Date Signed (mm/dd/yyyy) Check here if Delegated Official is a W-2 EmployeeTelephone NumberAuthorized Official’s Signature Assigning this Delegation (First, Middle, Last Name, Jr., Sr., M.D., D.O., etc.)Date Signed (mm/dd/yyyy)(blue ink preferred) all signatures must be original and signed in ink (blue ink preferred).
Delegated Official means an individual who is delegated by the “Authorized Official,” the authority to report changes and updates to the enrollment record.