If you can't get an answer from a federal agency in a timely fashion, or if you feel you have been treated unfairly, my office may be able to help resolve your problem or get you the information you need. While we cannot guarantee you a favorable outcome, we will do our best to help you receive a fair and timely response to your problem.

Residents of the Fourth Congressional District of Arizona can contact me for assistance in dealing with federal agencies. In order to better serve you, this form will generate a printable page that you should sign and mail to my office.

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 received from the agency involved;

Please Note:

The Privacy Act of 1974 (5 U.S.C. ยง 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.



Contact Information
Prefix * First Name * Last Name *
* Address:
* City:
State:
Zip:
* Phone Number:
* Email:
* Date of Birth:
* Social Security Number:
Case Information
* Agency Involved:
* Agency Case Number(s): (if none, indicate "None")
Branch of Service: (if applicable)
Military Rank: (if applicable)
* Nature of Problem


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