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SSA Forms

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10 files

  1. SSA REP PKG 2020 A

    SSA-1696 Claimant's Appointment of a Representative
    SSA-827
    SSA-3288
    SSA-1693 FEE AGREEMENT

    3 downloads

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    Updated

  2. SSA Rep Pkg 1

    Includes Dibcase merge fields for all forms
    SSA-1696 Claimant's Appointment of Representation
    SSA-1695  Identifying Information for Possible Payment of Authorized Fees
    SSA-1693 Fee Agreement for Representation Before the Social Security Administration
    SSA-827 Authorization to Disclose Information to the Social Security Administration

    2 downloads

       (1 review)

    0 comments

    Submitted

  3. SSA-1560 FEE PETITION REQUEST (10-2017)

    SSA merge fields added.
    Recommend add REP ID and REP full name separately.

    1 download

       (0 reviews)

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  4. SSA-8011 LOAN FORM WITH SSA-5062, SSA-5063

    Dibcase merge fields added. SSA-8011 form adds monthly expenses and creates total.

    2 downloads

       (0 reviews)

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    Submitted

  5. SSA-3288 Consent For Release of Information (11-2016)

    Dibcase merge fields added. Includes Electronic Signature block.

    0 downloads

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    0 comments

    Submitted

  6. SSA-521 Withdrawal Of Application (11-2018)

    Dibcase merge fields added

    0 downloads

       (0 reviews)

    0 comments

    Submitted

       (0 reviews)

    0 comments

    Submitted

  7. HA-4632 Claimants Medications (10-2012)

    Dibcase merge fields added

    0 downloads

       (0 reviews)

    0 comments

    Updated

  8. HA-4631 Claimants Recent Medical Treatment (06-2010)

    Dibcase merge fields added

    0 downloads

       (0 reviews)

    0 comments

    Updated

       (0 reviews)

    0 comments

    Updated

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