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Your Information

Prefix *

If not listed above

First Name *

Last Name *

Suffix

Rank

Branch

Address 1 *

Address 2

City *

State *

Zip Code *

Phone Number

Email Address *

Message Information

Please note: If you have an individual claim or difficulty involving your interaction with a federal agency, please select "Help with Federal Agencies" from the drop down menu below. For more information regarding the type of assistance I can provide, please click here.

Topic *

Agency *

The Privacy Act of 1974 requires that I have your written permission to make an inquiry on your behalf. In addition to submitting this contact form, please fill out, sign, and fax the appropriate privacy form to my Dallas office at 972-239-2110.

General Privacy Release Form

Immigration Privacy Release Form

EB-5 Immigration Privacy Form

Passport Intake Form

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Message (Please describe, in detail, the nature of the difficulties you are experiencing.) *

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