Facts to Assist Expediting a Representative Payee Application

In an effort to assist with the application process for a request for a Representative Payee, we here at Sterling Payee Services, wish to provide you with some helpful information. Please note that there is a set criterion that is required by the Social Security Administration in order for Sterling Payee Services to submit an application on behalf of you and/or your client.

  • Name and Social Security Number are required by the SSA.

  • Physical address is needed,
    (or if homeless, please state so).

  • Phone number and date of birth are needed.

  • Current Rep Payee and reason for the change.

  • It there is not a current rep payee, then a physician's statement is required by the SSA.

  • Do you live alone and if not who and what you pay for rent is required by the SSA.

  • The form labeled, "Advance Notification of Representative Payment" or the "SSA-4164" is required by the SSA. (This forms is always included in our Payee Request package.)

Forms

The following forms are in Acrobat PDF format and may be downloaded and printed.

Requirements for Rep Payee Form

Payee Request Form

Form SSA-4164

Budget Worksheet

Form SSA-787

If you do not have Acrobat Reader, you can download it here. Acrobat Reader is a free, downloadable program that will enable you to read the pdf files of the forms above.