Get Casework Authorization Privacy Act Release Form

Filling out the Casework Authorization Privacy Act Release Form is a crucial step for individuals seeking assistance from their representative. This guide will provide clear, step-by-step instructions to help you complete the form online with confidence.

Follow the steps to complete the form effectively.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter your full name in the designated field as it appears on your identification. Ensure accuracy to avoid any potential issues.
3. Fill out your street address and apartment number if applicable. This detail is important for correspondence.
4. Input your city, state, and zip code to provide a complete mailing address.
5. Enter your social security number in the specified field. This information is necessary for identification and verification purposes.
6. Provide your birthdate in the appropriate format to further verify your identity.
7. List your home phone and cell phone numbers where you can be easily reached.
8. Include your email address to receive updates regarding your inquiry.
9. If applicable, write your loan number to help identify the related case.
10. Input your agency or VA claim number if you have one, ensuring it is accurate.
11. Describe the type of assistance you are seeking from Congressman Coffman’s office. Include any relevant agency claim numbers and documents if necessary.
12. List any agency or agencies you have previously contacted regarding this matter.
13. Indicate whether you have contacted another Member of Congress about this issue.
14. State if you have hired an attorney to assist with your case.
15. Clarify if there is a pending court case related to your inquiry.
16. Describe in detail the problems you are experiencing with the agency or agencies involved.
17. Specify how you would like Congressman Coffman to assist you in resolving this matter.
18. Read and confirm your authorization under the Privacy Act of 1974 for governmental agencies to release information relevant to your case.
19. Sign the form to validate your request, and then enter the date of your signature.
20. Once you have completed all sections, save your changes, download the form, print a copy for your records, or share it as needed.

Complete your document online today for timely assistance!