Get Privacy Release Form - U.s. Senator Dan Coats - U.s. Senate

The Privacy Release Form for U.S. Senator Dan Coats is an essential document that allows constituents to authorize the senator's office to act on their behalf. This guide provides clear, step-by-step instructions on how to effectively fill out this form online.

Follow the steps to complete the Privacy Release Form effectively.

1. Press the ‘Get Form’ button to access the Privacy Release Form. This will allow you to open the document in your online editor for filling out.
2. Begin by entering your name in the designated field at the top of the form. This should be your full legal name, as it appears on official documents.
3. Fill in your date of birth in the provided format. Make sure to double-check the accuracy of this information.
4. Next, provide your full address, including your street number, street name, city, state, and ZIP Code. Ensure that the information is complete and correct for timely communication.
5. Enter your daytime phone number in the respective field. This should be a number where you can be easily reached.
6. In the next section, provide your night or cell phone number. This allows for alternative contact, if needed.
7. Input your email address in the designated space. Make certain it is accurate to receive updates and correspondence.
8. If applicable, enter your Social Security number, VA number, or receipt number in the corresponding field.
9. Indicate whether you have contacted any other elected officials regarding your case by selecting yes or no. If yes, provide their name in the field provided.
10. Clearly explain your request for assistance in the designated area. Be concise but thorough, and attach any relevant documentation. Remember to use additional sheets if necessary.
11. Sign the form to authorize Senator Coats and their staff to obtain information on your behalf, confirming compliance with the Privacy Act of 1974.
12. Lastly, date the form in the space provided, ensuring all information is complete. You can now choose to save changes, download, print, or share the completed form.

Complete and submit your Privacy Release Form online today to ensure your voice is heard.