Help with a Federal Agency

I know from experience that dealing with the federal government can be difficult and frustrating. There are many ways my staff and I can help North Carolinians resolve a problem or obtain assistance from a federal agency. My Constituent Advocates can help navigate government bureaucracies and intervene on your behalf.

Completing this online form will generate a privacy release for you to print and fill out. Federal privacy laws prohibit any federal agency from sharing information about you without your written authorization. Printing, signing, and returning that completed privacy release will provide your written authorization.

If you are a North Carolina resident stationed at a military base outside of the state, please include your home of record in the text of your message. If you are not a resident of North Carolina but are contacting us about a relative who lives in our state, please include their home address in the text of your message.

In the meantime, please call my office in Winston-Salem if you have any questions. North Carolinians can call toll free at 800-685-8916 or can call 336-631-5125.

My staff and I look forward to assisting you.

Mail Delay

Due to heightened security concerns in the U.S. Capitol, all mail sent to my Senate office in Washington, DC may be significantly delayed by security screening procedures. If your issue is urgent or time-sensitive, please call my office in Winston-Salem. North Carolinians can call toll free at 800-685-8916.

What is Casework

If you are having trouble solving a problem with a federal agency, my staff may be able to help. Due to the separation of powers, we are unable to assist with problems not related to federal agencies, such as judicial or state matters.

Title:

First Name:^*

Last Name:^*

Date of Birth:^*

Address:^*

Address (2):

County:

City:^*

State:^*

Zip Code:^*

Home Phone:^*

Work Phone:

Mobile Phone:

Fax:

Email Address:

Verify Email Address:

Social Security NumberPlease write on the printed copy

Specify your Request:^*

Application Number (if applicable):

Name of Issuer/Plan (if applicable):

Location of Claim, be specific (i.e. DDS, Office of Hearings/Appeals, etc.)

Case Number:

Place of Birth:

USCIS/DHS Number:

NVC/Consulate Case Number:

If your request relates to an IRS inquiry, Please Download THIS form and follow the instructions on the form.

Mortgage Holder (name of bank):

Account Number:

Have you contacted an approved housing counseling agency in your country?

Have you received a formal foreclosure notification?

If yes, your foreclosure date is:

The U.S. Department of State is currently experiencing extreme delays with regard to passport application processing. Officials are currently prioritizing life/death emergencies above all other applications, followed by business-related travel, then leisure trips.

Currently, leisure trip applications may take approximately 12-14 weeks (expedited) or 14-16 weeks (routine) to complete from time of submission. The most up to date information can be found on the U.S. Department of State website: travel.state.gov

If you have travel plans within the next four weeks (regardless of original filing date), it is recommended you provide payment information for an upgrade to expedited processing and a copy of your travel itinerary. In order for us to provide the most efficient service to you, please contact my Winston-Salem office to discuss your situation before submitting the Privacy Act release form.

Passport Locator

Claim Number:

Please list other individuals with whom you authorize the release of information on your case:

Relationship:

Name:

Relationship:

Name

NATURE OF PROBLEM: Please provide a complete statement on the reverse side of this form regarding the nature of the problem and the assistance needed from the office of Senator Richard Burr. Please attach copies of any additional pertinent documents.

Statement: