If you can't get an answer from a federal agency in a timely fashion, or if you feel you have been treated unfairly, our office may be able to help resolve a problem or get you the information you need. While we cannot guarantee you a favorable outcome, we will do our best to help you receive a fair and timely response to your problem.

This type of request is a multi-step process. Please complete as many fields in the form below as possible, required fields are noted. You will be contacted by staff in my office before we can inquire into your case.

You can also print, sign, and mail this authorization form with your signature to my office to begin the process.


Contact Information
* Prefix:
* First Name:
* Last Name:
* Email Address:
* Address:
* City:
* State:
* Zip Code:
* Phone Number:
Case Information
* What do you need help with?
 

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