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.
Step 1 of 2
To the best of my knowledge, I certify, under penalty of perjury, that 1) I provided or authorized all of the information in this privacy release and any document submitted with it; 2) I reviewed and understand all of the information contained in my privacy release and submitted with it; and 3) all of this information is complete, true, and correct.
I, (print your name)___________________________________ , authorize USCIS to release information contained in my USCIS records as relevant to checking my case status, and to the extent permitted by law, to Senator Tim Scott and the Member’s staff.
Signature (sign in ink):_________________________________________ Date: _______/ _______/ _______
Address:__________________________________________________________________________________
Phone:_________________________________________ Email: ___________________________
I am aware that provisions of the Privacy Act of 1974 (Public Law 93-579) may prohibit the release of information in covered agency files without my consent. I hereby give my consent for any applicable federal agency(ies) to release such information to the Office of United States Senator Tim Scott and/or members of his staff in connection with my case or claim.
Signature: _____________________________________ Date: _______/ _______/ _______
Print and then mail or fax your request to Senator Tim Scott at his state office closest to you: