If I intend to seek direct payment of the authorized fee on this claim. I declare under penalty of perjury that I have examined all of the information on this form and on all accompanying statements or forms, including any information, attestations and certifications provided to SSA in registration, and that they are all currently true and correct to the best of my knowledge.I agree that a copy of this signed form SSA-1696 will have the same force and effect as the original.I accept appointment as the representative for the claimant named in Section 2 of this form in connection with the claims and asserted rights described in Section 6 of this form.I am not disqualified from representing the claimant as a current or former officer or employee of the United States.I am not currently suspended or prohibited, for any reason, from practicing before the Social Security Administration.I will not disclose any information to any unauthorized party without the claimant's specific written consent.I understand that if I fail to comply with any of SSA's laws and rules I may be suspended or disqualified as a representative before SSA.I understand and agree that I will comply with SSA's laws and rules on the representation of parties, including the Rules of Conduct and Standards of Responsibility for Representatives I will not charge, collect, or retain a fee for representational services that SSA has not approved or that is more than SSA approved unless a regulatory exclusion applies.I accept this appointment and certify the following: Until now, there has been no requirement that a lawyer sign a 1696, but this form requires the representative (lawyers appear to be included)to initial this "Representative's Certification": The restrictions summary at the bottom of the tab will list the restrictions applied to that form by the Agency. On the dialog box that pops up, choose the "Security" tab. Under the file menu, choose "Properties". To see the security limitations applied to a particular form, open it in Acrobat Reader. You can't delete pages, add form fields, change the assembly of the forms, etc. It allows them to set the forms so that you, as an end user, can fill out only the provided form fields and print the forms. the Agency) to prevent end users from making multiple types of changes to the forms. It has rights management extensions that allow form authors (i.e. The software SSA uses to create and edit the forms is Adobe Livecycle. This has actually been the case for many years now - you just haven't run into it until this form. Even the forms SSA employees use internally are almost all similarly locked. The only ones that are not are older forms that haven't been updated in a long time. Most of the forms on SSA.Gov are locked from editing.
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