Privacy Release Form

The Privacy Act of 1974 requires that Members of Congress and their staff have written authorization before they can obtain information about an individual's case. Therefore, a consent form may be completed before we proceed with your issue.

For general casework, you can download the privacy release form here.

For veterans casework, you can download the privacy release form here.

For Immigration related casework, you can download the privacy release form here.

Please sign and return this form to:

Congressman Larsen’s Everett office
ATTN: Casework
2930 Wetmore Ave.
Suite 9F
Everett, WA, 98201

Or send by fax to (425) 252-6606.