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Help with Federal Agency

If you can't get an answer from a federal agency in a timely fashion, or if you feel you have been treated unfairly, my office may be able to help resolve a problem or get you the information you need. While we cannot guarantee you a favorable outcome, we will do our best to help you receive a fair and timely response to your problem.

Instructions

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.

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 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;

In order to better serve you, this form will generate a printable page that you must sign and mail or fax to my office:

Congressman Adam B.Shiff
87 N. Raymond Ave., Suite 800
Pasadena, CA 91103
Fax:(626)304-0572

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Your Information


Request Details




Print This Form

Use the “Generate Request” button to produce the document to authorize my office to help you. Please print, sign, date, and mail it to the address shown on the document. Please include any other documents or materials that you think would help my office help you.