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The forms available below are provided for the convenience of Summit's current and prospective clients.
The forms can be filled out online and printed.


How do I select Summit Payees Services to become my payee?


These three forms are the minimum required for Summit to be selected as payee:

Questionnaire Social Security SSA-4164 Medical Release


Summit Flyer Social Security SSA-795 Social Security SSA-787 Short Form Rental Agreement Special Request






These forms require the latest version of Adobe Acrobat Reader, which is

available as a free download from here.