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example below. Example: John Doe, his mark Witness's signature: _____________ Designated Authorized Representative The individual may authorize any adult to serve as his/her authorized representative to apply for AG. The statement designating the authorized representative must be in writing and is valid until (1) the application is denied, or (2) AG enrollment is cancelled, or (3) the individual changes his authorized representative by submitting a written statement revoking the prior designation or naming a new representative. Individual Cannot Sign When an individual cannot sign an initial or renewal application follow the procedure in the chart below. Detailed information follows. STEPS WHEN AN INDIVIDUAL CANNOT SIGN AN APPLICATION ACTIONS Step 1 Has the individual been judged legally incapacitated by a court of law, as evidenced by a copy of the conservator or guardian certificate of appointment in the record? YES: The authorized representative is the appointed conservator or guardian. STOP NO: The individual is competent. CONTINUE Step 2 Does the individual have an attorney in fact who has the power of