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Get SSA-1696-U4 2018-2021

Is release. If you will have more than one representative, check the appropriate block and give the name of the individual you want to be your principal representative. SSA will make contacts with, and send notices or requests for development to, only the principal representative. The principal representative will provide copies of notices or requests to other corepresentatives. You must sign and date the form. Print or type your address, area code and telephone number. If you are appointing a r.

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