SSA Form SSA-1696
Appoint someone to represent you in dealings with Social Security.
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About SSA Form SSA-1696
Form SSA-1696, Claimant's Appointment of a Representative, lets you name a person, such as an attorney or another qualified individual, to act for you in your business with the Social Security Administration. Your representative can help with your claim or appeal, get information about your case, and act on your behalf as allowed by the rules. You and your representative both complete parts of the form.
This page is a general guide and a fillable helper, not legal advice. Always download and file the current official form from the Social Security Administration at https://www.ssa.gov/forms/ssa-1696.html and confirm the fields and instructions match before you sign.
Who needs to complete it
- Claimants who want an attorney or other qualified person to represent them with Social Security.
- People who need help managing a claim, reconsideration, or appeal.
- Anyone who wants a representative to receive information about their case.
- Representatives who need a signed appointment on file with Social Security.
How to fill out SSA Form SSA-1696
- 1Enter the claimant's name and Social Security number or claim number.
- 2Enter the name and contact information of the representative you are appointing.
- 3Indicate whether the representative is an attorney or a non-attorney.
- 4Have the claimant sign and date the appointment section.
- 5Have the representative complete and sign the acceptance of appointment section.
- 6Complete the fee arrangement or waiver information if the form requests it.
- 7Submit the completed form to the Social Security office handling the claim.
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Frequently asked questions
What does SSA-1696 do?
It appoints a person to represent you in your business with Social Security, such as an attorney or another qualified individual. Both you and the representative complete parts of the form. This is a general guide, not legal advice.
Do I have to have a representative?
No. Having a representative is a choice. If you want one, this form is how you make the appointment official with Social Security.
Where do I send the completed form?
It generally goes to the Social Security office handling your claim. Check the current instructions for the correct submission method.
Is this the official SSA form?
This is a fillable helper to make completion easier. Always download and file the current official form from Social Security at https://www.ssa.gov/forms/ssa-1696.html and confirm the fields match.