TN 1 (07-10)
GN 03913.025 Paper Registration (Form SSA-1699) - Individual
A. Introduction for appointed representatives using the SSA-1699
Individuals serving as appointed representatives complete and submit Form SSA-1699 (Registration for Appointed Representative Services and Direct Payment) to:
Enroll for direct payment of fees, providing information we will reference whenever we receive a Form SSA-1696 (Appointment of Representative) and Form SSA-1695 (Identifying Information for Possible Direct Payments of Authorized Fees) related to a particular case, or
Update their registration information when it has changed, or
Initiate access to electronic services per GN 03913.020.
Representatives who previously registered for direct payment using the registration process in place prior to October 31, 2009, must complete a new paper Form SSA-1699 in its entirety to:
Revise their address, affiliation, or payment (by check or direct deposit) information, or
Provide additional information required to initiate access to certain electronic services (see GN 03913.020).
B. Procedure for completing and submitting the SSA-1699
We use Form SSA-1699 to:
Collect a representative’s personal information, including his or her home mailing address,
Request an attorney representative’s standing and information needed to verify his or her bar or court membership,
Specify mailing addresses other than the home address for receiving notices and Form 1099-MISC,
Identify the representative’s preferred payment method: by direct deposit or paper check,
Indicate employment affiliation with firms or organizations, and
Obtain required attestations and a signature under penalty of perjury.
Representatives may print a blank Form SSA-1699 for completion, or they may fill in the PDF form online from a link on our website at http://www.socialsecurity.gov/ar/ , prior to printing it. We recommend that the representatives fill in the PDF form online for legibility.
Representatives register and update their registration information by faxing Form SSA-1699, to the Office of Earnings Operations (OEO) in the Office of Central Operations (OCO) at 1-877-268-3827. Field offices and representatives should fax the forms, one form at a time, to this dedicated fax number. The field office shreds the SSA-1699, after successfully faxing the form to OEO.
NOTE: OEO does not input any forms related to appointed representatives other than Form SSA-1699, nor does OEO handle correspondence from representatives.
Click here to obtain the most current Form SSA-1699 in PDF format. Members of the public may complete and print the SSA-1699 from a link on our website: http://www.socialsecurity.gov/ar/ .