SSA-1693 Representation Fee Agreement – Fillable PDF

The SSA-1693 is the Social Security Administration’s standard representation fee agreement. Whether you are a claimant or a representative, this form outlines the permissible fees for services related to Social Security claims.

What Is the SSA-1693 Form?

The SSA-1693 captures the representative’s information, the claimant’s details, and the agreed‑upon fee structure (standard or two‑tiered). It is required whenever a professional represents a claimant in a Social Security matter.

How to Complete the SSA-1693 Online

Using Formize’s fillable PDF tool makes the process fast and error‑free. Follow these simple steps:

1. Click the "Fill out this form" button on this page.
2. Wait for the Formize PDF Filler app to load – it takes only a few seconds.
3. Enter the required information in each field. The form automatically saves your progress.
4. When finished, click Save & Download to get a completed PDF you can print or email.

Common Mistakes to Avoid

• Leaving the Representative ID blank: The ten‑digit Rep ID is mandatory for SSA processing.
• Mismatching addresses: Ensure the address on the form matches the one your representative gave you.
• Incorrect fee percentages: The standard fee cannot exceed 25% of past‑due benefits or $7,200 (whichever is less).
• Missing signatures: Both claimant and representative must sign; otherwise the agreement is invalid.

Download the Official PDF

If you prefer to work offline, you can download the original, government‑approved PDF below. The file is fully compatible with any PDF editor, but we recommend using the online fillable version for convenience.

Download SSA-1693 PDF