Appointment of Representative Form (SSA-1696)
Date:
To be completed by attorneys and advocates representing claimant, and signed by claimant.
| Attachment | Size |
|---|---|
| ssa-1696_representative.pdf (486.2 KB) | 486.2 KB |
To be completed by attorneys and advocates representing claimant, and signed by claimant.
| Attachment | Size |
|---|---|
| ssa-1696_representative.pdf (486.2 KB) | 486.2 KB |