Form SSA-1696 | Claimant’s Appointment of a Representative

If you have a case before us and need assistance, you can appoint a representative to help you. Your representative can be an attorney or a non-attorney, but must be qualified and comply with our published rules of conduct. Your representative may seek a fee, but many representatives do not charge a fee unless they win your case. A representative cannot charge or collect a fee from you unless we authorize it first.

If you do not have a representative and you are interested in getting one but do not know how to, your local Social Security office can give you a list of legal referral services and non-profit organizations, (such as legal aid services and local bar associations) that either provide services free of charge or help you find a representative.

If you decide to appoint someone to help you with your case, you must tell us in writing. You can sign and submit a written statement appointing the person, or use our standard form SSA-1696, Appointment of Representative. You can use our electronic version of the form by asking your representative to start an online submission where you both can complete your appointment electronically without personal contact. If you prefer to use the paper version, simply fill out the form online, print and mail it, fax it, or deliver it to us in-person.

Online SSA-1696 (e1696)
Paper SSA-1696

Where to send this form

Send the completed form to your local Social Security office. If you have any questions, you may call us toll-free at 1-800-772-1213 Monday through Friday from 7 a.m. to 7 p.m. If you are deaf or hard of hearing, you may call our TTY number, 1-800-325-0778.