Ssa 1696 u4-2026

1. Click ‘Get Form’ to open the SSA 1696 U4 in the editor.
2. Begin by completing Section 1, which requires your personal information and Social Security Number. If filing on behalf of someone else, include their details as the number holder.
3. In Section 2, authorize disclosure by checking the box. This allows your representative's staff to access necessary information regarding your claim.
4. If you have multiple representatives, specify your principal representative in Section 3. This person will be the main contact for SSA communications.
5. Both you and your representative must fill out Section 4 with complete information, including the Representative Identification Number (Rep ID).
6. Your representative should complete Section 5 to indicate their status and affiliations. Ensure they provide accurate certifications.
7. In Section 6, check all applicable claim types for which representation is sought.
8. Complete Section 7 if a fee arrangement is necessary. Your representative must indicate whether they will request direct payment or waive fees.
9. Finally, both you and your representative must sign and date Section 8 to validate the form before submission.

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