An individual member, employer, or beneficiary may appear in a proceeding governed by this chapter, either personally or through a representative duly authorized by a power of attorney executed by the individual, which provides the following information:

1. (a) Name, address, and telephone number of the individual member, employer, or beneficiary;
2. (b) Name, address, and telephone number of representative;
3. (c) Name and, if available, case number of the proceeding;
4. (d) Statements of authority granted to representative; and
5. (e) Signature of the individual member, employer, or beneficiary.

Source. #5225, eff 9-18-91; ss by #5880, eff 8-19-94, EXPIRED: 8-19-00 New. #7374, INTERIM, eff 10-13-00, EXPIRES: 4-11-01; ss by #7477, eff 4-10-01; ss by #7572, eff 10-10-01; ss by #12709, eff 1-9-19