- ssa 2026

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The document is the SSA-1696-U4 form used by individuals to appoint a representative for assistance with Social Security matters. It outlines the process for selecting a qualified representative, provides instructions for completing the form, and details the rights and responsibilities of both claimants and representatives. The form includes sections for the claimant's appointment, the representative's acceptance, and fee arrangements, emphasizing the need for authorization of fees and compliance with regulations.

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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 1, appoint your representative by providing their name and address. Ensure you check the appropriate program(s) under which you have a claim.
If you have multiple representatives, designate a principal representative and ensure they are aware of their responsibilities.
Complete Part 2 by having your appointed representative accept the appointment. They must sign and provide their details.
In Part 3, discuss fee arrangements with your representative. They can choose to charge a fee or waive it; ensure this section is completed accurately.
Finally, review all entries for accuracy before submitting the completed form to your local Social Security office.

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