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Get Corrine Brown Representative Form

1 Phone: (407) 290-9031 Fax: (407) 298-9717 PRIVACY ACT CONSENT FORM If you need assistance with a federal agency, please fill out this form as completely as possible and sign it where indicated. Under the Privacy Act of 1974, disclosure of personal records to a congressional office that is acting in behalf of a constituent is prohibited, unless the individual to whom the record pertains has consented. Please fax or mail this form to the nearest District office. Name:.

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