Ssa-1696 Form. Keep a copy of this form for your records. “us” and “ssa” means the social security administration.
Form SSA 1696 Appointing a Representative
This form is submitted to ssa as part of the complete application packet. You, the representative, can stop working for the claimant. Web form approved omb no. If you have a case before us and need assistance, you can appoint a representative to help you. Ad upload, modify or create forms. General information about this form revocation of a representative’s appointment In this document, “you” means the claimant, beneficiary, auxiliary or spouse. Representative's withdrawal of acceptance of an appointment. Complete, sign, and date the section below and submit it to one of our offices. Try it for free now!
Do not forget to enter the claimant’s social security number and your rep id. General information about this form revocation of a representative’s appointment In this document, “you” means the claimant, beneficiary, auxiliary or spouse. Keep a copy of this form for your records. You, the representative, can stop working for the claimant. This form is submitted to ssa as part of the complete application packet. Complete, sign, and date the section below and submit it to one of our offices. Ad upload, modify or create forms. Do not forget to enter the claimant’s social security number and your rep id. “us” and “ssa” means the social security administration. Sup1 (claimant’s revocation of the appointment of a representative) and sup2 (representative’s withdrawal of the acceptance of an appointment).
