Appointment of Representative

Individuals claiming rights or benefits under the Act must notify SSA in writing using our prescribed appointment form, Form SSA-1696, or the submittable electronic version, e1696, to appoint an individual to represent them in dealing with SSA. In addition, as part of SSA’s regulations, SSA requires both claimants and representatives to sign our prescribed form and file it with SSA before SSA will recognize the appointment. Claimants use Form SSA-1696, or e1696, to appoint a representative to handle their claim before SSA. They may also use the SSA-1696 (or e1696) to name their principal representative. Their selected representative(s) can use the SSA-1696, or e1696, to indicate whether they will charge a fee, to show their eligibility for direct fee payment, and to assign direct payment of their fee to an entity. In addition, representatives also use the SSA-1696, or e1696, to inform SSA of their disbarment; suspension from a court or bar in which they previously admitted to practice; or their disqualification from participating in or appearing before a Federal program or agency. SSA uses the information on the SSA-1696, or e1696, to document the appointment of the representative. We also use this form to collect the representative’s business affiliation and employer identification number. In addition, claimants may use the SSA-1696-SUP1 to revoke their appointment of a representative, and representatives may use the SSA-1696-SUP2 to withdraw their acceptance of the appointment. SSA uses the information on the SSA-1696-SUP1 and SSA-1696-SUP2 to document the revocation and withdrawal of a representative. Respondents are applicants for, or recipients of, Social Security disability benefits (SSDI); SSI payments; or anyone pursuing a benefit or invoking a right under SSA programs, who are notifying SSA they wish to appoint someone to represent them in their dealings with SSA; representatives being appointed by a claimant; as well as individuals revoking the appointment of a representative, and representatives withdrawing from an appointment.

The latest form for Appointment of Representative expires 2029-09-30 and is listed under ICR 202606-0960-009.

View the official OMB control history on Reginfo.gov.

Appointment of Representative - SSA-1696 and e1696

Federal Enterprise Architecture: Income Security - General Retirement and Disability

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