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information is obtained verbally, the date of the contact and the information received must be documented in the case record. Invalid Applications An invalid application is one that is not signed or is signed by someone that is not authorized to apply for the individual. The application is not accepted and must be returned to the individual for whom assistance is requested. A letter of explanation must be included with the returned application. Note: The application has multiple spaces for signatures. The application is valid if the individual or his/her representative signs in either the space labeled “Applicant’s or Authorized Representative’s Signature or Mark” or the one labeled “Name of Person Completing Application”. The application must be signed in one of these spaces to be valid. A signature on the front of the application is not sufficient. Who Can Sign the Application The application must be signed by the individual for whom assistance is requested unless the individual’s condition precludes him/her from doing so or he/she has designated an authorized representative to apply for him/her. If the individual is unable to sign the application the individual’s guardian, conservator or a family substitute relative may apply for him/her. Note: Under no circumstances may an employee of, or an entity hired by a medical service provider who stands to obtain Medicaid payment file an AG/Medicaid application on behalf of an individual who cannot designate an authorized representative. Signature By Mark If the individual cannot sign his or her name but can make a mark, the mark must be correctly designated (the individual's first and last name and the words "his mark" or "her mark" must be printed adjacent to the mark) and witnessed by one person as in the