CONSENT FOR RELEASE OF INFORMATION
One of my most important jobs is to be a liaison for constituents with various state related issues. To best serve we must comply with the provisions of the Privacy Act.
The Privacy Act of 1974 requires that written consent be obtained from you before information can be disclosed from a government agency’s record. So that I may legally act on your behalf, please complete and sign the following statement and return it to me. This form is available to the public free of charge.
Please click on the link to download the Consent for Release of Information Form.
One of my most important jobs is to be a liaison for constituents with various state related issues. To best serve we must comply with the provisions of the Privacy Act.
The Privacy Act of 1974 requires that written consent be obtained from you before information can be disclosed from a government agency’s record. So that I may legally act on your behalf, please complete and sign the following statement and return it to me. This form is available to the public free of charge.
Please click on the link to download the Consent for Release of Information Form.
privacy_act_consent_for_release_of_information.pdf | |
File Size: | 167 kb |
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