Form 1696 2011-2026

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4.4 out of 5

479 votes

The document outlines the process for appointing a representative to assist individuals with their Social Security matters. It details the responsibilities of both the claimant and the representative, including how to complete the appointment form, privacy considerations, fee arrangements, and the authorization required for representatives to charge fees. The document emphasizes the importance of selecting a qualified representative and provides guidelines on how representatives can act on behalf of claimants in various Social Security programs.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your full name and Social Security number at the top of the form. If applicable, include the wage earner's name and Social Security number.
In Part I, provide the name and address of the individual you are appointing as your representative. You can appoint more than one person if needed.
Check the appropriate boxes for the programs under which you have a claim, such as Title II (RSDI) or Title XVI (SSI).
If you wish to authorize your representative to designate an associate for administrative duties, check the corresponding box.
Sign and date the form at the bottom of Part I, ensuring to include your contact information.
In Part II, have each appointed representative sign to accept their appointment.
Complete Part III regarding fee arrangements. Your representative should select an option that reflects how they will charge for their services.

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Versions	Form popularity	Fillable & printable
2020	4.9 Satisfied (56 Votes)
2019	3.9 Satisfied (50 Votes)
2018	4.3 Satisfied (199 Votes)
2014	4.4 Satisfied (479 Votes)
2011	4.2 Satisfied (42 Votes)
2005	4.4 Satisfied (720 Votes)

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