Fillable Form SSA-1696-U4 (03-2011) - Appointment of Representative - SSA - ssa
Form SSA-1696-U4 03-2011 ef 03-2011 Destroy Prior Editions Information from these matching programs can be used to establish or verify a person s eligibility for Federally-funded or administered benefit programs and for repayment of payments or delinquent debts under these programs. If you appoint more than one individual as your representative you may want to complete a form for each of them. Part I Appointment...
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