Thank you for contacting our office for assistance. So we can
better serve you, it is our policy, and in certain circumstances
may be required by the Privacy
Act of 1974, to obtain written consent from our constituents
before we obtain information from public records or release
information to governmental or state agency. If you will complete
and sign the following, we will proceed. If you are representing
someone, it is necessary that the person represented sign this
form.
(Note:
This document is a public record, and if requested
by anybody, it must be open to that person’s inspection.)