Form SSA-1699 at a glance
What it is: Form SSA-1699, Representative Registration of the Social Security Administration, is completed to register as a representative or to update a prior registration.
Where and when to file: Complete this form and fax it to the Office of Central Operations at 1-877-268-3827.
You must register before the Social Security Administration can process your appointment as a representative submitted on a Form SSA-1696 or your designation as an entity Point of Contact (POC) on a Form SSA-1694.
A filled-in Form SSA-1699 example: a new representative fills in Section I
How to fill out Form SSA-1699, box by box
Your name and Rep ID
Enter your name exactly as it appears on your Social Security card.
If you want to use a different name, contact your local Social Security office to change the name currently in the records of the Social Security Administration. You must either receive a new card or receive confirmation that it processed your name change prior to completing this form.
If you already registered but need to update your information, enter your Rep ID.
Your date of birth and Social Security number
Enter Your Date of Birth (MM/DD/YYYY) and Your Social Security Number.
Your home mailing address
Enter Your Home Mailing Address: Street Line 1, Street Line 2, City, State and ZIP/Postal Code, with the Country (if outside the U.S.).
Do not enter a business address in Section I. If you choose to enter a separate business address, enter it in Section IV. You may also use the home address as your business address by checking the appropriate box in Section IV.
Your daytime phone, fax and email
Enter Your Daytime Phone Number with Country/Area Code, Phone Number and Extension. Your Home Fax Number (optional) has Country/Area Code and Fax Number. Your Email Address (Optional) is used for registration purposes and Social Security online service messages.
More rules for Form SSA-1699
In Section II, check one of the boxes. Are you currently in good standing and admitted to practice law before the U.S. Supreme Court; a U.S. Federal, state, territorial, insular possession, or District of Columbia court; or a member of a state bar if that membership carries with it the authority to practice law in that state? If you are not an attorney, please select “No”.
Yes (Go To Section III). No (Go To Section IV).
Section III is required if you answered “Yes” in Section II. Provide information for one state, U.S. territory, or U.S. Federal Court in which you currently are in good standing and have the right to practice law: Court Or Bar, Year Admitted (YYYY) and License Number (if one issued).
Section IV is required for all registrants. In 1, enter Your Home Address For Receipt Of Notices, or check Same as Home Address in Section I.
In 2, enter the Business Telephone Number (if different from that provided in Section I) and the Business Fax Number (optional). In 3, the Business Email Address is optional.
Did you check “Yes” in Section II OR have you been notified by the Social Security Administration that you are eligible for direct payment of your fees? If Yes, and you are eligible for and will seek direct payment of an authorized fee as an appointed representative, complete #5 and #6. If not, go to Section VI.
For 5, What is your preferred payment method? Direct Deposit to U.S. Bank - I am the owner or co-owner of this account (You must be the owner or co-owner), with the Type of Financial Account (Savings or Checking), Routing Number and Account Number. OR Check - Will be mailed to the Notice Address.
Your Tax Address is the address where the Social Security Administration will send your FORM 1099-MISC. Check Same as Home Address, or Same as Notice Address in 1 in this section.
Section V is required if affiliating with an entity: complete it if your work as a representative will be affiliated with a firm or organization, and you are eligible for and will seek direct payment of an authorized fee. If you work for more than one firm or organization, complete and attach as many copies of this section as needed. You will need the firm's or organization's EIN in order to complete this section.
Enter the Employer Identification Number (EIN) (See your W-2 or contact the firm or organization to get this number.) and the Name of Firm or Organization.
Section VI is required for all registrants. You MUST ATTEST to these statements and complete the following questions. Mark I attest.
In 2, have you ever been: a. Suspended or prohibited from practice before SSA or any other federal program or agency? b. Disbarred or suspended from a court or bar to which you were previously admitted to practice as an attorney? c. Convicted of a violation under Section 206 or 1631(d) of the Social Security Act? d. Disqualified from epresenting a claimant as a current or former officer or employee of the United States? Mark Yes or No for each.
For each Yes answer in 2, provide the information regarding that event (attach copies of the page if you need more space.): Federal Program or Agency; or Court or Bar Name, Bar Number (provide the Bar Number if you have one AND you answered "Yes: to 2b), Year Admitted (provide the year if you answered "Yes" to 2b), Beginning Date of and Ending Date (if ended), and Brief Description of Circumstances.
If your situation is different
General Information and Instructions
Do not fax registration forms for more than one individual at the same time.
While you may attach multiple copies of Section V of this form, do not attach other documents to this form. The Social Security Administration cannot process any other documents received at this fax number.
You will receive a notice containing your Representative Identification (Rep ID) once your initial registration is complete. You will receive a Rep ID even if you are registering only to serve as a POC. Allow 2 to 3 weeks to receive your notice.
If the Social Security Administration is unable to process the form you submit, it will notify you. It does not return incomplete or inaccurate forms. If forms are incomplete or inaccurate, you will have to submit a new form with complete and accurate information.
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.
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.
Perjury Statement
The Perjury Statement is required for all registrants: you declare under penalty of perjury that you have examined all of the information on this application and it is true and correct to the best of your knowledge.
Sign the Signature of Person Identified in Section 1 (You must sign your OWN name) and fill in the Date.
Section VII: General Attestations
Section VII is required for all registrants. Mark I attest.
If you fail to comply with SSA laws and rules, you could be criminally punished by a fine or imprisonment or both, and you could be subject to civil monetary penalties.
Sources
[1] Form SSA-1699 (09-2024), Representative Registration, Social Security Administration (the Official source link on this page).
