Get Privacy Act Release Form Representative Steven Palazzo Fourth ... - Palazzo House

Filling out the Privacy Act Release Form is essential for authorizing the disclosure of your personal information by federal agencies to your U.S. Representative, Steven Palazzo. This guide will provide a clear, step-by-step process to ensure that you complete the form accurately and effectively.

Follow the steps to fill out the Privacy Act Release Form accurately.

1. Click the ‘Get Form’ button to obtain the Privacy Act Release Form and open it in your preferred document editing tool.
2. Fill in your last name, first name, and middle initial in the designated fields. Make sure to provide accurate information as it will be used for identification.
3. Enter your complete address, including city and zip code. Providing an accurate address helps ensure proper communication regarding your case.
4. Indicate your county, email address, and phone numbers in the respective fields. It is important to provide multiple contact methods.
5. Provide your date of birth and Social Security Number (SSN). This information is required for identity verification purposes.
6. If applicable, fill out the third-party information, including their name and relationship to you. This allows them to handle your request if necessary.
7. If your matter relates to the U.S. military or Veterans Affairs, complete the additional fields for branch of service, dates, rank, and home of record.
8. Indicate whether you have had combat service and provide details of the conflict if applicable.
9. If you have previously contacted another congressional office about this matter, specify this by answering the yes/no question and providing the name of that office if applicable.
10. In the space provided, explain the issue you are facing and the outcome you desire. You may attach additional pages or relevant documentation if necessary.
11. Read the authorization statement carefully. After ensuring that all the information is accurate, sign and date the form at the bottom.
12. Save your changes to the document. You can then download, print, or share the completed form as required. Finally, return the form to the designated district office for processing.

Complete your Privacy Act Release Form online today for timely assistance with your case.