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DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICESForm CMS1696 Approved OMB No. 09380950APPOINTMENT OF REPRESENTATIVE Name of Party Medicare Number (beneficiary as party)

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What is i appoint form individual?

i appoint form individual is a form used to appoint an individual as an authorized representative for tax purposes.

Who is required to file i appoint form individual?

Any individual who wants to appoint someone else to act on their behalf for tax-related matters needs to file i appoint form individual.

How to fill out i appoint form individual?

i appoint form individual can be filled out by providing the necessary personal information of both the appointer and the appointed individual, along with the details of the authorization.

What is the purpose of i appoint form individual?

The purpose of i appoint form individual is to officially designate an individual to handle tax matters on behalf of another individual.

What information must be reported on i appoint form individual?

The form requires personal information such as names, addresses, Social Security numbers, and relevant tax information of both parties.

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