This service allows you and the individual you agree to represent (the claimant) to complete your respective sections of Form SSA-1696 online, sign the form electronically, and submit it to us electronically. Before you begin, you will need the following information:

• Your valid email address.
• The claimant's valid email address.
• Your Representative Identification (RepID) (this is the number you were assigned when you registered with us).

IMPORTANT: Submission of this form is a two-step process for each signer. We will not receive or process the form until both parties have completed their steps.

Step One. You, the Representative, must complete your designated sections of the form, sign the form electronically, and submit it to Adobe Sign.

Before beginning the form, you will first enter your and the claimant’s email addresses into the application online.

You will also create a password that will be required for you and the claimant to access the form. You should provide the password to the claimant by phone, in person, or SMS text message (standard message and data rates may apply). If you are unable to contact the claimant by phone, in person, or by text, then you may send the password via a separate email message.

You will receive an email from adobesign@adobesign.com containing a link and instructions on how to access the form.

NOTE: After you sign the form, the claimant will also receive an email from adobesign@adobesign.com containing a link and instructions on how to complete their portions of the form and submit it to SSA.

The form will be available to you and the claimant for 15 calendar days after you initiate the process online (i.e., when you enter your and the claimant’s email addresses in order to receive a link to complete the form). You should inform the claimant about the importance of taking action in response to this email upon receipt of the email. If you and the claimant do not complete, sign, and submit the form within fifteen (15) calendar days, you will need to start a new form.

Step Two. Upon receipt of email notification that the first step has been completed by you, the claimant accesses and reviews the partially completed form, completes their designated sections, signs the form electronically, and submits the form to us.

After successful submission of the form, adobesign@adobesign.com will send an email to you and the claimant with a link to the submitted form. This will allow you to save a copy for your records.

We will notify you and the claimant by mail when your form has been processed.

PLEASE NOTE:

• This website is most compatible with the following browsers: Microsoft Edge and Google Chrome.
• After 60 minutes of inactivity, the system will end your session, the form will delete the information you entered during the session, and you will have to repeat the first step again.
• If you (or the claimant) do not see an email notification within a few minutes of submission, check your junk folder. If you do not receive an email, you will need to submit a new form. We recommend that you verify the accuracy of your and your claimants' email address.
• A daily email reminder will be sent to you and the claimant until the form has been submitted or until the time expires.
• If you or the claimant lose the password, we do not have the ability to reset the password. You will have to restart the process.