Personal Authorization Form

You will need to complete a Personal Authorization Form before my staff can look into matters on your behalf. Below are common questions about the form and links to the form itself in both English and Spanish.

What is the Personal Authorization Form and why do I need to complete one for you to make inquiries on my behalf?

The Personal Authorization Form is required under the Right to Privacy Act. It simply is a form on which you give some basic information about yourself - your name, address, phone number and Social Security number - and then sign your name. By doing this you are giving me permission to contact an agency on your behalf. This is to protect you from having people get information about you without your permission.

Do I have to come to one of your offices to get a Personal Authorization form?

No, you can either print one here or contact one of my state offices and ask them to send you one.

  • Personal Authorization Form (English) - (Word | PDF)
  • Personal Authorization Form (Spanish) - (Word | PDF)
  • Personal Authorization Form for IRS help (English) - (Word | PDF)
  • Personal Authorization Form for IRS help (Spanish) - (Word | PDF)

PREPARE TO OPEN A CASE

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DETERMINE IF YOUR ISSUE IS CASEWORK

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FEDERAL AGENCY LINKS

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