Social Security Claimant's Appointment of a Representative
Official owner Social Security Administration
Official document
Open the official form
- Issued by
- Social Security Administration
- Form number
- SSA-1696
- Last checked
- Sep 30, 2026
Opens the copy posted by Social Security Administration. Revision shown on our record: Dec 2024. Before using it, confirm the form number and revision match.
Appoint a qualified attorney or nonattorney representative for a pending SSA claim or appeal.
What problem this helps solve
Appoint a qualified attorney or nonattorney representative for a pending SSA claim or appeal.
Who completes it: Claimant and chosen representative; representative starts electronic appointment when using that method.
What this does not prove
Official instructions and the person's notice control; an application is not an eligibility or approval decision.
Dated source check
Official destination checked
Maintained page and six-page 12-2024 UF form read; both signatures and pending-case scope verified.
Last checked Sep 30, 2026. A working link does not establish the current edition, suitability, agency acceptance, or service availability.
Steps for using this form
Use the official pathway
No One Left Outside's preparation notes summarize the dated sources in this record. Follow the agency's official instructions and current edition when they differ.
1. Check that this route fits
- Stage and purpose
- Appoint a representative in a pending claim/appeal
- Who completes it
- Claimant and chosen representative; representative starts electronic appointment when using that method.
- Jurisdiction
- United States
- Application mode
- Electronic with representative; Print and mail/fax; In person
2. Prepare before starting
- Confirm a pending SSA matter and who will represent the person.
Documents named by the source
- Pending claim/appeal identification and representative details; any fee agreement is a separate document.
- Fees and fee waivers
- Representative fees may apply and require SSA authorization; free representation availability UNKNOWN.
- Account
- Electronic process has identity/signature steps; exact current account requirements UNKNOWN.
- Appointment
- UNKNOWN — arrangements with representative and SSA vary.
- Signature
- Both claimant and representative sign.
- Third-party certification or assessment
- Unknown — confirm any certification, referral, or assessment with the official owner.
3. Follow official submission instructions
Read official instructions- Representative-initiated electronic SSA-1696
- Print and mail/fax/deliver to local SSA office
4. Get help or an accommodation
- Social Security — 800-772-1213; TTY 800-325-0778
Get help with the actual claim, report, appeal, payee or card task. Ask SSA which office provides that service and whether an appointment is needed before traveling.
Languages: English source read; other versions UNKNOWN.
Accessibility: External source conformance was not evaluated; request agency assistance for an inaccessible process.
5. Know the supported next step
- Keep appointment/fee documents and follow SSA communications.
Restrictions and unresolved details
- This form does not make the representative a payee.
- Choosing a representative is optional; authorization does not promise a claim outcome.
Official instructions and the person's notice control; an application is not an eligibility or approval decision.
Continue with your journey
Return to the connected step to decide what to do next. Opening this record does not complete that step or submit an application. If the official route is unavailable, use the assistance options above or browse help in the journey.
Applying for SSI or SSDI
Appoint a representative
Return to step: Decide whether you want free help
Form record
Adds to a private plan in this browser tab. Nothing is sent to the provider, and nothing is applied for.
- Official title
- Social Security Claimant's Appointment of a Representative
- Form number
- SSA-1696
- Program
- Representation in Social Security claims
- Jurisdiction
- United States
- Revision / edition
- Dec 2024
- Who completes it
- Claimant and chosen representative; representative starts electronic appointment when using that method.
- Signature
- Both claimant and representative sign.
- Submission methods
- Representative-initiated electronic SSA-1696, Print and mail/fax/deliver to local SSA office
- Supporting documents
- • Pending claim/appeal identification and representative details; any fee agreement is a separate document.
- Languages
- English source read; other versions UNKNOWN.
- Accessibility
- External source conformance was not evaluated; request agency assistance for an inaccessible process.
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Before sharing information
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- • Read the agency’s privacy and consent language before entering personal information.
- • Save a confirmation or reference number if one is provided.
- • If a page asks for payment unexpectedly, stop and confirm the fee with the agency.
Source note: Official instructions and the person's notice control; an application is not an eligibility or approval decision.
No One Left Outside does not process this form, receive your answers, decide eligibility, or represent the agency. A destination check does not confirm current funding, acceptance, or an outcome.
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