To begin having your case processed, please complete all of the information below. Service request forms must be signed by the individual seeking assistance:

In order to provide better service to my constituents, I have two district offices in California. The offices are located in Walnut Creek and Richmond. Both offices are open from 8 am to 5 pm PST.

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.

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 Date of Birth;
  • Alien Registration#:;
  • USCIS Receipt#:;
  • 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;

Please Note:

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.

Authorization Form

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.

In accordance with the Privacy Act of 1974, I give Congressman Mark DeSaulnier authority to act on my behalf.

  marks required fields of data.

Your Information
Contact Information
Contact Numbers

What are these options?
This is to help the constituents that are hard of hearing or use a video phone alert us to that fact so we can use the proper technology when we need to call them. The default option "Voice" is a normal audible telephone.

Casework Information

Please also include the following information:

*Please attach copies of any supporting documentation or additional pages if needed to explain explanation of your request.

Print This Form

Use the Generate Request for Review button to produce the document to authorize our office to help you. Then sign it and mail, fax, or hand deliver it to the address shown on the document. Please include any other documents or material that you think would help our office help you.