Residents of the 4th Congressional District of California can contact me for assistance in dealing with Federal agencies. In order to better serve you, this form will generate a printable page that you should sign and mail to my office.
Please include all pertinent information and claim numbers in your correspondence—such as:
- Your Social Security number for a case involving Social Security;
- Your Alien Registration Number for an immigration related case;
- 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.
The Privacy Act of 1974 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.
Please send the form to: Office of Congressman Tom McClintock, 2200A Douglas Blvd., Suite 240, Roseville, CA, 95661
* indicates information that you need to provide.