Fill Free fillable Form SSA1696U4 2018 Form to Appoint a
Ssa-1696 Form. Complete, sign, and date the section below and submit it to one of our offices. Web form approved omb no.
Fill Free fillable Form SSA1696U4 2018 Form to Appoint a
Web this article walks you through the form and provides tips for its completion. This form is submitted to ssa as part of the complete application packet. Do not forget to enter the claimant’s social security number and your rep id. In this document, “you” means the claimant, beneficiary, auxiliary or spouse. General information about this form revocation of a representative’s appointment Title ii title xvi title xviii title viii Web form approved omb no. Sup1 (claimant’s revocation of the appointment of a representative) and sup2 (representative’s withdrawal of the acceptance of an appointment). Ad upload, modify or create forms. Keep a copy of this form for your records.
Do not forget to enter the claimant’s social security number and your rep id. Complete, sign, and date the section below and submit it to one of our offices. Web form approved omb no. “us” and “ssa” means the social security administration. In this document, “you” means the claimant, beneficiary, auxiliary or spouse. Sup1 (claimant’s revocation of the appointment of a representative) and sup2 (representative’s withdrawal of the acceptance of an appointment). Keep a copy of this form for your records. Ad upload, modify or create forms. Representative's withdrawal of acceptance of an appointment. If you have a case before us and need assistance, you can appoint a representative to help you. You, the representative, can stop working for the claimant.
