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 form below gives our office permission to contact a federal agency or department on your behalf.
Please 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.
We must have your signature to proceed with this type of request.
This is a three step process:
- Fill in the form with the required data, then click the “Generate Request for Review” button at the bottom of the page.
- Review the form to ensure all data is accurate, then sign the form.
- Print and mail, fax, or hand deliver the document to our office. The address and fax number are on the generated page.