Help with a Federal Agency

Residents of the 11th Congressional District of North Carolina, contact us for assistance in dealing with Federal agencies.

CLICK HERE: Submit your casework digitally or fill out the form below and print.

To streamline your inquiry, please be prepared to provide information such as:

Your Social Security number for a case involving Social Security
VA claim number for a case with Department of Veterans Affairs
Taxpayer identification number (Social Security number, if individual) for an Internal Revenue Service problem, etc.
Your address, home phone number and daytime phone number (if different than home) so that we can obtain any additional information from you that might be necessary
Copies of any related documents or correspondence that you may have from the agency involved

Please Note:

The Privacy Act of 1974 (5 U.S.C. § 552a) requires that Members of Congress or their staff have written authorization before they can obtain information about an individual's case.

We must have your signature to proceed with this type of request.

Indicates required field

Your Information

Prefix:

First Name:

Last Name:

Suffix:

Casework Details

Agency Involved:

Agency case numbers or None

Social Security Number:

This form requires you to print, sign and mail, fax, or hand deliver the signed copy. Your social security number will not be transmitted electronically.

Branch of Service: (If Applicable)

Military Rank: (If Applicable)

Date of Birth:

Month

Day

Year

Your Contact Information

Address

Address 2

City

State

ZIP Code

Email:

Telephone

Phone Number

Phone Type:

What are these options?

Constituents who are hard of hearing or use a video phone have the option to choose TDD or VP based on the type of device they are using. This allows our office to respond to them accordingly. The default option 'Voice' is a standard audible telephone.

Your Message

Please Explain the Problem: