Flag Request Form

On behalf of the Fifth Congressional District of Iowa, I am happy to fulfill constituent requests to have a United States flag flown over the United States Capitol.

Flags may be flown for a particular person, event, or organization and may (pending flag office delays) be flown on a specific date. Priority is given to flags being flown in memorial of the deceased. A certificate of recognition is included with each flag and there is no limit on the number of flags you may order.

To obtain a flag through my office, please fill out our flag order form below.

Please note: We can only process flag requests from constituents in Iowa's Fifth District or requests being sent to a constituent in the fifth district. If you are not in Iowa's Fifth District please contact your congressional representative to order a flag.

Purchaser's Information

Purchaser's name :
Street address :
Address, line 2 :
City :	, State :
ZIP :	+4
E-Mail Address
Phone number:	(for questions regarding your order)

The next address is where the order will be sent. This information must be filled in.
To copy the purchaser's information into the fields below, click the following checkbox:

Shipper's Information

Ship To Name :
Street address :
Address, line 2 :
City :	State:
ZIP :	+4
Phone number	(for questions regarding delivery problems)

Flag Information

Size	Material	Quantity Flown Over the Capitol	Quantity NOT Flown Over the Capitol
3'x5'	Nylon	@ $13.05	@ $9.00
3'x5'	Cotton	@ $13.30	@ $9.25
4'x6'	Nylon	@ $17.55	@ $13.50
5'x8'	Nylon	@ $22.05	@ $18.00
5'x8'	Cotton	@ $24.05	@ $20.00

Flag Certificate Information

If you choose to have your flag flown over the United States Capitol, please complete the following information for the certificate. If you have multiple flags to fly, they must all be flown on the same date. If you have multiple flags to fly on the same date, and you would like different names and/or occasions to appear on each certificate, please leave the name and occasion information below blank, and use a separate document to enclose that information.
Flag will be presented to	(name as it should appear on the certificate)
Special occasion
* Requested date for flag to be flown
Please submit your request at least five weeks ahead of your desired date. Clicking on “Calculate Prices” will calculate shipping costs and the total amount due, and will show the results in the order request page that can be printed for mailing.

Flag Request Form

Contact Info

District Offices