Get Request For Appointed Representative's Direct Payment Information

What Is Form SSA-1696-U4? Social Security Form SSA-1696-U4 is a form that allows you to appoint a third party to represent you when you deal with the Social Security Administration (SSA). You can choose to have an attorney as your representative or you can appoint any qualified individual you wish.

You must complete form SSA-11 (Request to be selected as payee) and show us documents to prove your identity. You will need to provide your social security number, or if you represent an organization, the organization's employer identification number.

appointed to represent claimants in dealings with us. • Representative Identification (Rep ID) – a 10-character ID that we assign. You will use this Rep ID in lieu of your. Social Security Number (SSN) if you need to update information on this form.

SSA-1699 Request Registration of Individuals and Staff for Appointed Representative Services.

To be appointed as the applicant's representative, the case manager must complete the SSA-1696: Appointment of Representative form.

If you have a case before us and need assistance, you can appoint a representative to help you. Your representative can be an attorney or a non-attorney, but must be qualified and comply with our published rules of conduct.

An appointed representative is an exempt person in relation to a regulated activity comprised in the carrying on of that business for which the person's principal has accepted responsibility (section 39,FSMA).

If you wish to withdraw your acceptance of the appointment, you must sign and date the withdrawal and file it with us either in- person at your local field office, mail it, or fax it to us. You should also tell the claimant. Your withdrawal will take effect on the date we receive the signed document.