REPRESENTING THE THIRD DISTRICT OF MISSISSIPPI
 COMMITTED TO CREATING JOBS, DRIVING DOWN SPENDING AND SHRINKING THE SIZE OF THE FEDERAL GOVERNMENT.

Federal Agency Help

Having trouble with a federal department or agency? Congressman Gregg Harper's congressional office may be able to help.

Under the Privacy Act of 1974, federal agencies are prohibited from disclosing information from your files to anyone without your written authorization. By completing this form and signing the Privacy Act statement below, you are authorizing the federal agency involved to disclose such information to Congressman Gregg Harper and members of his staff. Such information will be kept confidential.

Please complete the requested information below, print and mail, email or fax to Congressman Harper's Pearl office.

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

Your Information
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Your Spouse Information (if applicable)


If the assistance needed is with the military or Veterans Affairs, please provide the following information
city where service member enlisted


Nature of Problem
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Print This Form

Use the Generate Request button to produce the document to authorize Congressman Harper's 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 Congressman Harper's office help you.

* indicates information that you need to provide.