Privacy Release Form - Congressman Hank Johnson - hankjohnson house Preview on Page 1

Privacy Release Form - Congressman Hank Johnson - hankjohnson house 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your name and selecting your gender (M or F) in the designated fields.
  3. Fill in your date of birth, address, city, state, and zip code accurately to ensure proper identification.
  4. Provide your home, cell, and business phone numbers along with your email address for communication purposes.
  5. Indicate whether you would like to subscribe to Congressman Johnson’s e-newsletter by checking 'Yes' or 'No'.
  6. If applicable, specify if you have an attorney or veteran service representative assisting you and provide their contact information.
  7. Complete the identifying information section including Social Security Number, Alien Number, Veterans Claim Number, and any other relevant details.
  8. Describe the nature of assistance you are requesting in the provided space. You may attach additional documentation if necessary.
  9. Review the Privacy Act statement and sign at the bottom of the form. Print your name clearly beneath your signature.
  10. Return the signed form to the specified address via mail or fax as indicated at the bottom of the document.

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Georgias 4th congressional district is a congressional district in the U.S. state of Georgia. The district is currently represented by Democrat Hank Johnson, though the districts boundaries have been redrawn following the 2010 census, which granted an additional congressional seat to Georgia.
Henry Calvin Johnson Jr. (born October 2, 1954) is an American lawyer and politician serving as the U.S. representative for Georgias 4th congressional district since 2007. He is a member of the Democratic Party.
Democratic Party Hank Johnson / Party

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