Form SSA-1696 (09-2019) UF-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin with Section 1, where you will enter your personal information, including your Social Security Number and contact details. If filing on behalf of someone else, include their information as the number holder.
3. In Section 2, authorize disclosure by selecting the appropriate box. This allows SSA to share information with your representative's staff.
4. If you have multiple representatives, specify your principal representative in Section 3. This person will be the main point of contact for SSA communications.
5. Complete Section 4 with both your and your representative's information, ensuring to include the Representative Identification Number if applicable.
6. Your representative must fill out Section 5 regarding their status and affiliations. They should also certify their compliance with SSA rules.
7. Indicate the type of claim in Section 6 by checking all relevant boxes that apply to your situation.
8. In Section 7, clarify any fee arrangements if applicable. Your representative will indicate whether they are requesting a fee or waiving it.
9. Finally, both you and your representative must sign and date Section 8 to validate the form before submission.

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