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Appointment of Representative - Form SSA-1696


Representatives are usually attorneys, but need not be. Representatives must abide by standards of conduct which the Social Security Administration (SSA) has published. In addition, most representatives will not charge a fee, unless they win your case. In any event, a representative cannot charge a fee until SSA approves that fee.

If you do not know the name of a representative in your area, your local SSA office can provide a list of representatives for you to choose from. At the hearing level, representatives are involved in approximately 70 percent of our cases.

If you decide to have a representative, you must sign and submit to SSA a written statement appointing him or her to represent you in your dealings with SSA. Use Form SSA-1696 (Appointment of Representative) for this purpose.


How to Obtain the Form

Below you will find Form SSA-1696 (Appointment of Representative) in Portable Document Format (PDF). To print the PDF version, you will need the Adobe Acrobat reader software. If you do not already have this special software, see our page on downloading and printing PDF documents.

After you download the Adobe Acrobat Reader, come back to this page and download the PDF version of the SSA-1696:

PDF Icon Appointment of Representative, Form SSA-1696
Print the PDF SSA-1696 on 8 1/2 x 11 inch white paper.


How to Complete the Form

Instructions for completing and signing Form SSA-1696 (Appointment of Representative) are on the form.


Where To Send The Form

Mail or deliver the form to your local Social Security office. If you are not sure where your local office is located, try our Social Security Office Locator service or call 1-800-772-1213.  
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Last reviewed or modified Monday Jan 14, 2008
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