Get Ssa-1696-u4 2018-2025

The SSA-1696-U4 form is used to appoint a representative to assist you with Social Security matters. Completing this form online allows you to conveniently choose a representative while ensuring accurate and timely processing of your claim. This guide provides step-by-step instructions to help you fill out the form correctly and efficiently.

Follow the steps to complete the SSA-1696-U4 form online.

1. Press the ‘Get Form’ button to access the SSA-1696-U4 form and open it in your chosen editor.
2. At the top of the form, enter your full name and Social Security number. If your claim is associated with another individual's work, include the 'wage earner's' name and their Social Security number.
3. In Part 1, you will appoint your representative. Provide the individual's name, and select the type of claims under which you need representation (Title II, Title XVI, Title XVIII, or Title VIII).
4. Indicate if you wish to permit your representative to designate associates to receive information from your claim file on their behalf by checking the appropriate box.
5. If you have more than one representative, select your principal representative and provide their name and address.
6. Sign and date the form. Also, print or type your address and phone number.
7. In Part 2, the designated representative must complete and sign the acceptance of their appointment, stating their eligibility and conditions for representation.
8. Part 3 involves the fee arrangement. The representative must select one of the options regarding fee payment, sign, and date this section.
9. After reviewing the completed form for accuracy, save your changes. You can then download, print, or share the form before submitting it to your local Social Security office.

Begin filling out your SSA-1696-U4 form online today to appoint your representative and manage your Social Security claims effectively.