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Ssa 1695-2026
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- Click ‘Get Form’ to open the SSA 1695 in the editor.
- Begin by filling out the 'Information About the Claimant' section. Enter the first name, middle name, last name, and suffix of the claimant. If applicable, include the wage earner's Social Security Number and their name if different from the claimant.
- In the 'Type of Benefits' section, specify whether you are representing for Title II (RSDI) or Title XVI (SSI) benefits. Ensure that you provide the correct Social Security Number associated with these benefits.
- Next, complete your information as the representative. Input your name, Social Security Number, mailing address including city, state, country, and ZIP code. If you're representing as part of a firm, include the Employer Identification Number (EIN).
- If you are representing other claimants not mentioned above, list their Social Security Numbers and names in the designated area. If there are more than five claimants, attach a separate document.
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Related links
the receipt of a notice from the Social Security Administration indicating a ... (n) Concurrent SSI and supplemental nutrition assistance applications by ...
REVISION 03/01/2018: We are revising EM-12004 REV 3 to update the processing steps of the form SSA-1695 (Identifying Information for Possible Direct payment ...
Published in Bulletin of The Seismological Society of America (BSSA) by Seismological Society of America (SSA). 1976 Volume 66, p1695-1711 ...