Let's walk through this form together, one step at a time.
Let's Get Started
Take a deep breath. This form might look official and a little intimidating, but you're not alone in filling it out. We'll go through it together, one field at a time.
What Is This Form?
The SSA-1696 is how you officially tell Social Security: "I want this person to represent me in my case."
Once you sign it and Social Security approves it, that person becomes your "representative." They can:
Get copies of your case documents from SSA
Talk to SSA on your behalf
Represent you at hearings or in appeals
Negotiate on your behalf
Who Usually Needs This Form?
People often appoint a representative when:
They're appealing a denial
They're dealing with an overpayment dispute
They don't feel confident handling SSA correspondence on their own
An attorney or advocate is helping them with their case
The Big Idea
This form has two sections:
Section I: You fill this out. You're saying "I appoint this person as my representative."
Section II: Your representative fills this out. They're saying "I accept this appointment and I agree to follow SSA rules."
It's straightforward once you understand who does what.
💡 Tip: Before you start, make sure your representative is ready to sign Section II. They need to sign this form themselves—you can't do it for them.
What You'll Need
Before you start filling out the form, gather these items. It'll make the process smoother.
About You
Your Social Security number
Your date of birth
Any letter from Social Security about your case (especially a denial letter)
Your claim number, if you have one (it's on SSA letters)
About Your Representative
Their full legal name
Their mailing address
Their phone number
Their fax number (if they have one)
Their email address (if they have one)
If they're an attorney: their state bar number
Discussion about how they'll be paid (fee agreement, fee petition, or no fee)
Good to Know
Call your representative and confirm their contact information before you start. It's easier to ask them now than to have to correct a typo later.
💡 Tip: If you don't have your claim number, don't worry—SSA can look you up by your name and Social Security number.
Section I: About You
This is the part you fill out. You're telling Social Security who you are and who you're appointing as your representative.
What Happens Here
In this section, you'll write:
Your full name, Social Security number, and claim number (if you have one)
Your representative's contact information
What type of representative they are (attorney, non-attorney, or organization)
What issues they can represent you on
Your signature and date
Important
Your signature is critical. You must sign this form yourself. SSA will reject it if someone else signs for you (unless you have a power of attorney, which is rare).
Your signature says: "I'm appointing this person, and I understand what that means."
Your Name, SSN, and Case Number
This is straightforward—just make sure the name matches your Social Security card exactly.
Print exactly as it appears on your Social Security card (no nicknames)
Why? SSA matches this against their records. If it doesn't match exactly, they may reject the form.
9 digits (with or without dashes)
Why? This links the form to your case file. Without it, SSA can't find you.
If you have one, it's on any letter from Social Security
Why? It helps SSA route your form faster. But if you don't have it, they can still find your case with your name and SSN.
💡 Tip: Double-check your SSN for typos. One wrong digit and the form gets misfiled.
Your Representative's Contact Information
Write your representative's information clearly. This is how SSA will send documents and communicate about your case.
Use their legal name (not a nickname)
Important: This name must match what they sign in Section II. If it doesn't, SSA may reject the form.
Where should SSA send documents?
Why? If SSA can't read the address, your representative won't get case documents. Write it neatly.
Best number to reach them
Speeds up document delivery
For electronic correspondence
Type of Representative & Scope
Tell SSA what type of representative you're appointing and what issues they can handle.
Check one box
Why? SSA needs to know if they're verifying a law license or just recording the appointment.
What can your representative handle? Check all that apply.
OR check individual issues:
What Most People Do
Most people check "All issues related to the claim" so their representative can handle whatever comes up. This is the simplest approach.
💡 Tip: If you only want your representative to handle appeals (not overpayments, for example), check just those boxes. But discuss this with your representative first.
Your Signature (Section I)
🚨 Critical
You must sign this form yourself. No one else can sign for you (unless you have a legal power of attorney, which is rare). SSA will reject the form if someone else's signature is here.
Use your normal signature (the one on your checks or driver's license)
[Sign here on the printed form]
When you sign it
What Your Signature Means
By signing this, you're telling Social Security: "I understand that I'm appointing this person as my representative. I trust them to act on my behalf."
It's a real commitment, so take a moment to make sure you're comfortable with it.
Section II: Your Representative's Part
Now your representative takes over. They fill out the rest and sign. You don't fill this part out.
What Your Representative Does Here
Your representative will:
Confirm their contact information
Make a legal declaration that they're authorized to represent you
Decide on a fee arrangement (how they'll be paid)
Decide whether they want direct payment from SSA
Sign and date the form
If they're an attorney, provide their bar number
Important: The Signature in Section II
Your representative must sign Section II themselves. You can't sign it for them. SSA will reject it if the wrong person signs.
Make sure the name they sign matches the name you wrote in Section I, Block 4.
Fee Arrangement Overview
Your representative will choose one of three paths:
Fee Agreement: You and they agree on an amount upfront (e.g., "$2,000" or "20% of back pay")
Fee Petition: They ask SSA for approval after you win (usually 25% of back pay, capped at $6,000)
No Fee: They volunteer (common with legal aid)
💡 Tip: Before you give your representative the form to sign, discuss the fee arrangement. Don't leave it as a surprise.
Understanding Fee Arrangements
It's important to talk about money upfront. This prevents confusion and arguments later.
Fee Agreement (Pay Upfront)
You and your representative agree on a set fee before they start work.
Example: "I'll pay you $1,500" or "20% of my back pay."
You know the cost in advance.
Many attorneys use this approach.
Legal limit: Attorney fees can't exceed 25% of back pay or $6,000 (whichever is less)—unless SSA approves more.
Fee Petition (Ask SSA After)
Your representative works first, then asks SSA to approve a fee afterward.
Example: You win $10,000 in back pay. Your representative asks SSA to approve a $2,000 fee (20%).
You don't pay upfront—it comes from your back pay.
SSA usually approves reasonable amounts (25% of back pay is typical).
Good option if you're not sure what to offer.
No Fee (Volunteer)
Your representative doesn't charge anything.
Legal aid organizations often do this.
Some pro bono attorneys work this way.
Your representative will note this on the form.
Waiver of Direct Payment
What it means: If you check this box, SSA pays your representative directly (and they deduct their fee). If you don't check it, your money comes to you, and you pay them.
Most people don't check this because they want to keep control of their money. Discuss it with your representative.
What to Do With the Completed Form
After You Sign, Your Representative Signs
You complete Sections I and sign.
Give the form to your representative.
They complete Section II and sign.
You now have a fully executed form.
Mail the Form to SSA
Send it to the Social Security office handling your case. You can:
Mail it: Check the address on any SSA letter about your case, or call 1-800-772-1213 to ask which office to send it to.
Bring it in person: Walk into your local SSA office and hand it to a representative.
Ask about e-filing: Call and ask if your office accepts online submission.
What Happens Next
Processing time: 7–14 days after SSA receives it (usually).
If complete: You'll get a notice saying your representative is officially appointed.
If there's a problem: SSA will contact you or your representative to fix it (illegible writing, missing signature, mismatched names, etc.).
💡 Tip: Keep a copy for your records. If SSA says they never received it, you have proof you sent it.
Important Reminder
This form gives your representative real power over your case. Make sure you trust them and that they understand what they're agreeing to.
Once it's approved, changing your mind takes time and effort. Think it through first.
You're Ready!
You've learned what you need to know. Here's a quick summary before you print and fill out the form.
Section I (You Fill This Out)
Your name, SSN, claim number✓
Representative's full name and address✓
Representative's phone, fax, email✓
Type of representative (attorney, non-attorney, organization)✓
Scope of representation (what they can handle)✓
YOUR signature and date✓
Section II (Your Representative Fills This Out)
They confirm their information✓
They choose a fee arrangement✓
They decide on direct payment (if applicable)✓
THEIR signature and date✓
Their bar number (if attorney)✓
Next Steps
Print the SSA-1696 form (OMB #0960-0509) from ssa.gov
Fill out Section I carefully, write clearly
Sign and date Section I
Give the form to your representative to sign Section II
Mail or bring it to your local SSA office
Keep a copy for your records
Questions?
Call Social Security at 1-800-772-1213 (voice) or 1-800-325-0778 (TTY). They're available Monday–Friday, 7 a.m. to 7 p.m.
Or visit ssa.gov and search for "SSA-1696."
You've completed the SSA-1696 Form Guide. Dr. Ed's 24help.org — Your trusted source for benefits information.
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