Residents of the 11th Congressional District of California can contact me for assistance in dealing with Federal agencies. To start this process, my office will need your written authorization.
Complete and digitally sign a privacy authorization form or complete the fields in the Authorization Form below and generate a printable page that you can sign and return via fax or by mail to one of the district offices.
Please contact us at my Walnut Creek Office (phone 925-933-2660, fax 925-933-2677) or Richmond Office (phone 510-620-1000, fax 510-620-1005) if you need assistance with issues of federal jurisdiction in any of the following areas:
- Medicare and Medicare Part D
- Social Security
- Veteran's Affairs
- Internal Revenue Service (IRS)
- Federal Worker's Compensation
- Public Housing
- Small Business Administration
- Federal Retirement
- Educational Financial Aid
Please include all pertinent information and claim numbers in your correspondence
In order to better serve you, this form will generate a printable page that you should sign and mail to our 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 an 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. Step one is to fill in the form with the required data, then click the “Generate Request for Review” button at the bottom of the page. Once reviewed, print and mail, fax, or hand-deliver the document to our office. The address and fax number are on the generated page.