Effective Dates: 10/18/2011 - Present Previous | Next

DI 12095.115 Form SSA-1696-U4 (Appointment of Representative)

Go to OS 15020.285 to obtain the most current form.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0412095115
DI 12095.115 - Form SSA-1696-U4 (Appointment of Representative) - 10/18/2011
Batch run: 01/14/2019
Rev:10/18/2011