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USSSARev. 04-2023

Official form guide

Form SSA-1696: Appointment of Representative

Appoints an attorney or non-attorney as your representative to act on your behalf in Social Security matters, including appeals and hearings.

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Form Overview

SSA Form SSA-1696 - Appointment of Representative

Appoints an attorney or non-attorney as your representative to act on your behalf in Social Security matters, including appeals and hearings.

An official appointment of representation that grants your representative legal authority to act on your behalf in SSA matters.

Risk Radar

Scan points
  • 1Representative not signing or completing their section — the appointment is invalid.
  • 2Failing to specify fee arrangement — if fees will be charged, complete the fee agreement or petition.
  • 3Using an outdated form — SSA only accepts current versions.

Plain English

Use this form when you want a lawyer or advocate to represent you in dealings with SSA — such as during a disability appeal or hearing.

Submission Date

  • Filing date: Before a hearing, appeal, or any SSA proceeding where you want legal representation.
  • Preparation window: collect IDs, supporting records, and signatures in advance.
  • Final review: verify names, dates, and required fields before submission.

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Glossary Terms

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Field map

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9 fields

Claimant

4 items

Claimant Name

Your full legal name.

Requiredtext
Social Security Number

Your SSN.

Requiredssn
Claimant Signature

Your signature authorizing the representative.

Requiredsignature
Date Signed

Date you signed the form.

Requireddate

Representative

5 items

Representative Name

Full name of your attorney or advocate.

Requiredtext
Address

Representative's business address.

Requiredtext
Phone Number

Representative's phone number.

Requiredtext
Attorney/Non-attorney Status

Indicate whether the representative is an attorney or not.

Requiredselect
Representative Signature

Representative's signature accepting the appointment.

Requiredsignature

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Quick Facts

Claimants who want to authorize another person (attorney, non-attorney advocate, or organization) to represent them before SSA.
An official appointment of representation that grants your representative legal authority to act on your behalf in SSA matters.
Before a hearing, appeal, or any SSA proceeding where you want legal representation.
Submit to your local SSA office, ALJ hearing office, or Appeals Council.
SSA requires formal appointment before a representative can access your records or receive SSA communications on your behalf.
Both you and your representative must sign. The representative section requires their credentials and contact information.

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Source transparency

Copyright & Licensing - US Government Forms

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Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Verify current license terms with the source agency before reuse outside this platform.

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