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Get the free Form SSA 1696 Claimant's Appointment of a Representative. Appointment of Representative

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Form SSA1696 (XX2023) UF Discontinue Prior EditionsInstructions for Completing Form SSA1696Page 1 of 6Keep a copy of this form for your records DO NOT FILE Form SSA1696 if you do not have a claim,
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Gather all necessary information such as your personal details, Social Security number, and contact information.
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Carefully read the instructions provided on the form SSA 1696.
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Who needs form ssa 1696 claimants?

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Individuals who are appointing a representative to help with their Social Security claim or appeal process.
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Representatives who are being appointed by an individual to assist with their Social Security claim or appeal.
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Form SSA-1696 is the Appointment of Representative form that allows claimants to appoint a representative to help them with their Social Security or Supplemental Security Income (SSI) claim.
Claimants who wish to have a representative assist them with their Social Security or SSI claim are required to file form SSA-1696.
To fill out form SSA-1696, claimants must provide their personal information, the representative's information, and sign the form to authorize the representative to act on their behalf.
The purpose of form SSA-1696 is to authorize a representative to act on behalf of the claimant in Social Security or SSI proceedings.
The form requires information such as the claimant's name, Social Security number, contact information, the representative's name, contact information, and their relationship to the claimant.
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