Initial Inquiry Request Form

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I am aware that the Privacy Act of 1974 prohibits the release of information in my file without my approval. I hereby authorize Congresswoman Cathy McMorris or her representative to inquire with the following agency on my behalf:

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Prefix: (select one) Mr. Mrs. Ms. Mr. and Mrs. Miss Dr. Hon. Rev. Rabbi Admiral Commander Colonel General Lieutenant Lt. Col. LCDR Major Private Sergeant Petty Officer

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Suffix: Jr. Sr. M.D. Ph.D I II III

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State:* WA

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• Regrettably, I am unable to reply to any email from constituents outside of the 5th District of Washington.

Please note: By federal law (18 USC, Sec. 205), neither Congresswoman McMorris nor her staff can involve themselves in private legal matters or represent constituents in judicial proceedings.