Congressman David Scott Media Authorization Form (GA-13)
The Privacy Act of 1974 prohibits the federal government from releasing any information from personal files of individuals without the express written permission of the person involved. Disclosure of personal records to a Congressman acting on behalf of a constituent is prohibited, unless the individual to whom the record pertains has consented.
Your private information is confidential, by submitting this form you confirm that you authorize the office to use the receipts of your casework success as an example for media purposes that are included but not limited to social media sites, newsletters, and websites.