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Opening an Inquiry with My Office

If you need assistance with a personal case issue, in accordance with the Federal Privacy Act of 1974, we must have a signed privacy release form outlining your problem or a signed letter which clearly states your issue. This provides our office permission to look into the matter on your behalf. (non-digital version)

Once you have determined that your problem is one with which I can be of assistance, you should follow the steps listed below to gather necessary information and material before you contact my office. This will help my staff to assist you more efficiently.

STEP ONE: Complete a Privacy Release Authorization Form Under the Federal Privacy Act of 1974

We must have a signed privacy release form which clearly states your issue. This provides our office permission to look into the matter on your behalf. Please include any relevant case or alien numbers and supporting documents which relate to your inquiry.

STEP TWO: Gather necessary paperwork

You must provide my staff with any paperwork you have regarding your case. This might include letters from the agency, medical forms, and other forms and documents relating to your problem.

The agencies listed below require additional information. My staff will need this before they can make inquiries on your behalf:

Internal Revenue Service Cases: The IRS uses its own Authorization Form which you must complete before they will respond to an inquiry from my office. You can either print this form by clicking the link below, or request one through the mail by calling my office at 1-800-866-2701.

Office of Personnel Management Cases: The OPM uses your CSA or CSF number as well as your Social Security number, and, in some cases your Date of Birth is helpful. To report the death of an annuitant and to apply for survivor benefits, you will need the death certificate.

Social Security Cases: You need to apply for Social Security Disability benefits (SSD) before you contact my office. Once you have applied, my staff will need to have information on the office at which you filed your claim or appeal and where you are in the process.

Veterans Affairs Cases: For these cases your C# would be helpful along with your Social Security Number.

Workers' Comp Cases: Your case number along with your Social Security Number will help us track your case.

Immigration Cases: Need a alien number and case number


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    Comments (optional)
    repName John Smith  
    helpWithFedAgencyAddress Haverhill District Office
    1234 S. Courthouse
    Haverhill, CA 35602
    district 21st District of California  
    academyUSCitizenDate July 1, 2012  
    academyAgeDate July 1, 2012  
    academyApplicationDueDate October 20, 2012  
    repStateABBR AZ  
    repDistrict 1  
    repState Arizona  
    repDistrictText 1st  
    SponsoredBills Sponsored Bills  
    CoSponsoredBills Co-Sponsored Bills  
  • Office Locations

    Office Name Location Image Map URL
    Washington DC 2229 Rayburn House Office
    Washington, DC 20515
    Phone: (202) 333-4455
    Fax: (202) 333-5522
    Haverhill Office
    Serving Haverhill County
    1234 East. Courthouse
    Haverhill, CA 35602
    Phone: (202) 333-4455
    Fax: (202) 333-5522
    South Office
    10 Welcome Street
    Tuesdays & Thursdays
    9:00 AM- 11:00 AM