SSA-1691 PDF Form & Guide

Quick answer

What is SSA-1691 used for?

This form records an appointment, withdrawal, registration, fee agreement, or fee request for representation before SSA. It is separate from the claimant’s underlying benefit application or appeal.

Use the form for the exact transaction in its title. Follow any accompanying SSA letter because it may contain a return address, barcode, deadline, or case-specific instruction.

For SSA-1691, the transaction named by the government is “Eligible Non-Attorney Representative Application.” Use that title to distinguish this PDF from forms that collect related facts but produce a different agency action.

What to prepare before filling SSA-1691

01
Confirm that SSA-1691 — Eligible Non-Attorney Representative Application — matches the action described in your SSA, CMS, or IRS notice. Similar form numbers may serve different programs or review stages.
02
Gather claimant and representative identifiers, the matters covered, appointment history, entity and tax details when relevant, and any fee agreement, itemization, or payment evidence requested.
03
Download a fresh copy of SSA-1691 from the official link below. SSA warns that browser PDF viewers may not fill forms consistently, so save the PDF and use current Adobe Reader when needed.
04
Write names, Social Security or claim numbers, dates, addresses, and amounts exactly as they appear in the records you are using. Mark nonapplicable items as the instructions direct instead of inventing an answer.
05
Review SSA-1691 for signatures, dates, attachments, continuation pages, and any case-specific return instructions. Keep a complete copy and delivery record.

Questions specific to “Eligible Non-Attorney Representative Application”

Use these prompts to test whether your records actually support the subjects named in the official SSA-1691 title.

Before signing, can you independently recheck every date, amount, relationship, or identifier connected with “eligible” rather than relying on the working draft?
Would an attachment about “non” make the answer clearer, and if so, does it identify SSA-1691, the relevant person, and the question it supports?
If an agency reviewer asks about “attorney,” can you trace the SSA-1691 entry to a named person, document, account, notice, or event?
Would an attachment about “representative” make the answer clearer, and if so, does it identify SSA-1691, the relevant person, and the question it supports?
If an agency reviewer asks about “application,” can you trace the SSA-1691 entry to a named person, document, account, notice, or event?
How does “identity” relate to the specific eligible non-attorney representative application transaction, and have you kept unrelated background information out of the response?

Evidence review

Gather claimant and representative identifiers, the matters covered, appointment history, entity and tax details when relevant, and any fee agreement, itemization, or payment evidence requested.

Before you sign

Make the scope and signatures consistent across related representative forms. Appointment, direct-payment registration, fee authorization, withdrawal, and claimant revocation are distinct actions.

A reliable way to complete SSA-1691

Map the source records

Make a one-page source index before typing. List each record, the person it concerns, its date range, and the questions it can support. When two records disagree, place both in the index and resolve the difference with an explanation; do not copy whichever value is easiest. This approach gives every important answer a traceable basis and exposes missing periods early.

Review fields and branches

Keep factual answers and advocacy separate. Enter the requested fact in the field, then use the designated explanation area to supply context. Do not replace a date, amount, duty, limitation, or relationship with a conclusion. Clear facts make it easier for the agency to understand the request and decide whether more evidence is needed.

Package and track the filing

Use the return channel tied to the form and case. A field office, hearing office, processing center, online account, fax number, and mailing address are not interchangeable. When a notice supplies a barcode or return envelope, keep those routing elements with the submission unless updated official instructions say otherwise.

Official SSA-1691 PDF and resources

These government links were verified in the SSA forms directory on 2026-08-09. Download a fresh PDF before filing because agencies can revise forms and instructions.

English SSA-1691 PDF

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Prepare SSA-1691 from your records

Add the blank government PDF and your source documents. Clerks AI can map supported facts to fields and flag gaps for review. You remain responsible for eligibility, signatures, accuracy, evidence, and submission.

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SSA-1691 FAQ

Is SSA-1691 free to download?

Yes. SSA says all forms in its official directory are free. Use the government PDF link on this page; do not pay a third party merely for the blank form.

Can I fill SSA-1691 in a web browser?

Possibly, but SSA says browser PDF viewers do not work consistently for filling or screen reading. Download the file and use current Adobe Reader if fields, saving, or accessibility features do not work correctly.

Where do I submit SSA-1691?

Follow the address, office, upload route, or case-specific instruction in the PDF and any notice you received. The SSA directory says paper forms may generally be mailed or faxed unless the form states otherwise, but not every form uses the same destination.

Related representatives & fees forms

SSA-1560

SSA-1691: Eligible Non-Attorney Representative Application