Form Ssa-1699 - Registration For Appointed Representative Services And Direct Payment
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8Registration for
Appointed Representative Services and Direct Payment
Purpose of Form
Complete this form if you:
•
want to register for direct payment of fees,
•
registered for direct payment of fees prior to 10/31/2009 and need to update your information,
registered as an appointed representative on or after 10/31/2009 and need to update your information, or
•
•
received a notice from the Social Security Administration instructing you to complete this form.
NOTE: If you are not in the business of providing services to Social Security claimants and beneficiaries, but will be
appointed as a representative for a relative, friend, or other acquaintance, YOU DO NOT NEED TO COMPLETE THIS
FORM.
This form also collects information necessary to conform to Internal Revenue Code sections 6041 and 6045(f), which
require us to issue IRS Form 1099-MISC to individuals who represent claimants and receive direct payment of $600 or
more during a tax year.
General Information and Instructions
•
Complete this form and fax it to the Office of Central Operations at 1-877-268-3827. Do not fax more than one
Form SSA-1699 at a time.
•
You will receive a notice containing your Representative Identification (Rep ID) once your initial registration is
complete. Allow 2 to 3 weeks to receive your notice.
•
If you are currently suspended or disqualified from representing claimants in dealings with the Social Security
Administration, you may not register until your suspension has ended or we have reinstated you.
•
You must update your registration by completing a new form if your personal,
professional,
or business affiliation
information changes including information related to disbarments,
suspensions,
or sanctions.
•
We may return incomplete or inaccurate forms.
•
For more information, please call 1-800-772-6270 or visit our website at If you are
hearing impaired, call our TTY number at 1-800-325-0778. You may also visit your local Social Security office.
Explanation of Terms for Completing This Form
•
Representative – an attorney or individual other than an attorney who meets all of our requirements and is
appointed to represent claimants in dealings with us.
•
Representative Identification (Rep ID) – a 10-character ID that we assign. You will use this Rep ID in lieu of your
Social Security Number (SSN) if you need to update information on this form.
Form SSA-1699 (09-2013)
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