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Help with a Federal Agency

One of the most important things I do as a U.S. Representative is help people navigate issues with the federal government. Although I cannot override the decisions made by a federal agency, I can often intervene on a person's behalf to answer questions, find solutions, or just cut through the red tape.

If this is a time sensitive issue, please call my district office directly at 330-599-7037 or 440-783-3696. Due to the volume of requests my office receives on a daily basis I want to be sure to assist you as quickly as possible if this is an urgent matter.

In order to serve you, my office will need a completed version of the form below. Please fill out this form, print it off, sign and mail or fax to our office.

Please be sure to include all pertinent information and claim numbers in your correspondence—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. You will review, print, and sign the document after it's generated from the information you enter below.

If you need help with an immigration issue, please download, fill out, and mail/fax this completed privacy release form in addition to filling out the form below. 

If you need help with an IRS issue, please download, fill out, and mail/fax this completed privacy release form in addition to filling out the form below. 


Authorization Form

This is a three step process:

  1. Fill in the form with the required data, then click the "Generate Request for Review" button at the bottom of the page.
  2. Review the form to ensure all data is accurate, then sign the form.
  3. Print and mail, fax, or hand deliver the document to our office.  The address and fax number are on the generated page.

In accordance with the Privacy Act of 1974, I give Representative Anthony Gonzalez authority to act on my behalf.

* marks required fields of data.


Your Information
Today's Date: *
Prefix: *
First Name: *
Last Name: *
Street Address: *
City: *
State: *
Zip Code: *
Phone Number: *
Email: *
Date of Birth: *
Social Security Number:

Please do not include your social security number if your case inquiry is immigration-related. This form requires you to print, sign and mail, fax, or hand deliver the signed document. Your social security number will not be transmitted electronically.
Agency/Military Information
Agency Involved: *
Agency Case Number(s): * (if there is no case number, indicate "None")
Branch of Service: (if applicable)
Military Rank: (if applicable)
Immigration-Related Information
U.S. Citizenship and Immigration Services Alien #:
U.S. Citizenship and Immigration Services Form #:
U.S. Citizenship and Immigration Services Receipt #:
Place of Birth (City, Country)
Additional Details
Please Explain the Problem: *

Print This Form

Use the "Generate Request for Review" button below to produce the document to authorize our office to help you. Print, sign, and mail, fax, or hand deliver it to the address shown on the document. Please include any other documents or material that you think would help our office help you.

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