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Form SSA-1696 | Appointment of Representative | SSA You can sign and submit a written statement appointing the person, or use our standard form SSA-1696, Appointment of Representative You can use our electronic version of the form by asking your representative to start an online submission where you both can complete your appointment electronically without personal contact
Appointment of Representative Use this form to appoint a representative to act on your behalf for your claim, appeal, grievance or request By signing this form and appointing this representative, you agree that the representative will be the main contact and have authority to make requests, present evidence, get information, and receive all communication about your action
Complete your Form SSA-1696 Complete your Form SSA-1696 This service allows you and the individual you agree to represent (the claimant) to complete your respective sections of Form SSA-1696 online, sign the form electronically, and submit it to us electronically Before you begin, you will need the following information: Your valid email address
Appointment of Representative - hcan. net How to Complete This Form Please print or type At the top, show your full name and your Social Security number If your claim is based on another person's work and earnings, also show the ''wage earner's'' name and Social Security number If you appoint more than one person, you may want to complete a form for each of them
Claimants Appointment of a Representative - Allsup I accept appointment as the representative for the claimant named in Section 2 of this form in connection with the claims and asserted rights described in Section 6 of this form I agree that a copy of this signed form SSA-1696 will have the same force and effect as the original
Establishing Representative Role: Completing Form SSA-1696 Completing the SSA-1696: Appointment of Representative form is very important so that both SSA and DDS can communicate with you about the application and ask any questions that they might have This article walks you through the form and provides tips for its completion
Instructions for Completing Form SSA-1696 You or your representative must file the completed form with us, in-person at your local field office, by mail, or by fax Review and complete all required sections
SSA - POMS: GN 03910. 040 - Appointment of a Representative - 01 31 2025 Claimants must use our standard Form SSA-1696 (Claimant’s Appointment of a Representative) for the appointment For more information about who can be an appointed representative, and the authority and responsibilities of a representative, see GN 03910 025 For the scope of an appointment, see GN 03910 040A 3
Representing Claimants - SSA Learn how to get appointed as a representative and file an initial claim or appeal Form SSA-1696 will appoint you as a representative on a claim or update your appointment information A fee agreement is used to formalize the fee arrangement between representatives and claimants