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DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICESForm Approved OMB No. 09380950APPOINTMENT OF REPRESENTATIVE Name of Party Medicare Number (beneficiary as party) or
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What is 18 printable ssa 1696?
18 printable ssa 1696 is a form used for the appointment of a representative by the Social Security Administration (SSA).
Who is required to file 18 printable ssa 1696?
Individuals who are unable to manage their Social Security benefits on their own may need to file 18 printable ssa 1696 to appoint a representative to help them.
How to fill out 18 printable ssa 1696?
To fill out 18 printable ssa 1696, you will need to provide information about the applicant, representative, and the type of benefits being managed. The form must be signed by both the applicant and the representative.
What is the purpose of 18 printable ssa 1696?
The purpose of 18 printable ssa 1696 is to authorize a representative to manage an individual's Social Security benefits on their behalf.
What information must be reported on 18 printable ssa 1696?
Information such as the applicant's name, Social Security number, details of the representative, and the specific powers granted to the representative must be reported on 18 printable ssa 1696.
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