Privacy Release Form

If you are seeking basic information about federal programs, these questions can often be answered by phone.  However, if you have an individual problem involving a federal agency or program, the Privacy Act of 1974 requires that I have written authorization before an agency will provide any information about you.

Please print out and complete a Privacy Release Form [PDF 45.4KB] [MSWord Doc] to begin the process.  It is helpful to provide all the information that will be needed to start work on your behalf.  Social Security numbers or case numbers are routinely required as well as details about your situation.  It is also helpful if you can provide copies of documents or correspondence related to your case.

This page accesses PDF documents.  You will need Adode Reader to access these documents.