If you are a resident of the Third District of Michigan and experiencing difficulty with a federal agency or department, our office may be able to help. The following form gives our office permission to contact a federal agency or department on your behalf.
Please be prepared to include all pertinent information and claim numbers in your correspondence—such as:
- Your Social Security number for a case involving Social Security;
- VA claim number for a case with Department of Veterans Affairs;
- Taxpayer identification number (Social Security number, if individual) for an Internal Revenue Service problem, etc.;
- Your address, home phone number and daytime phone number (if different than home) so that we can obtain any additional information from you that might be necessary;
- Copies of any related documents or correspondence that you may have from the agency involved.
The Privacy Act of 1974 (5 U.S.C. § 552a) requires that members of Congress or their staff have written authorization before they can obtain information about an individual's case.
If you do not know the four digit +4 extension for your ZIP code, please check the U.S. Postal Service website for more information.
Please call our Grand Rapids office for assistance if you have difficulties completing this form.