Assistance with a Federal Agency

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

* indicates information that you need to provide.

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

Your Information

Today's Date:

Full Name: *

Agency Involved: *

Branch of Service: (If Applicable)

Military Rank: (If Applicable)

Agency case number(s): (if there is no case number, indicate "None") *

Date of Birth: *

Social Security Number: *

Street Address: *

City: *

State: *
OK

Zip Code: *
[zip5]

+4 Extension:
[zip4]

*Email:

Telephone

Telephone Number: *

Voice

VP

TTD

Nature of Problem

Please Explain: *

Print This Form

Use the Generate Request button to produce the document to authorize my office to help you. Then sign it and mail it to the address shown on the document. Please include any other documents or material that you think would help my office help you.

Contact Congressman Lankford

Welcome to the on-line office for Congressman James Lankford. Please visit the Contact Me page to contact James electronically or click on the office location nearest you for details.