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Click ‘Get Form’ to open it in the editor.
Begin by providing your contact information. Fill in your name, address, email, and telephone numbers in the designated fields.
Describe your relationship to the beneficiary clearly. Specify if you are filing for a sibling, spouse, parent, child, or yourself.
Indicate any other elected officials you have contacted regarding your issue by listing their names.
Select the applications you have filed from the provided options and include the dates filed.
Provide relevant information for the beneficiary including their case number, alien number (if applicable), name, date of birth, country of citizenship, and country of origin.
Attach a short letter explaining your matter and copies of any relevant documents or notices before signing and dating the form.
Finally, return this signed form along with all supporting materials to Senator Chris Van Hollen at the specified address.
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Requesting Your Records Under the Privacy Act 552a, as amended, allows individuals to gain access to their own personal records subject to certain exemptions, and to seek correction or amendment of records maintained by Federal agencies that are inaccurate, incomplete, untimely, or irrelevant.
Who is the beneficiary in the privacy release form?
The Privacy Release must be signed by the petitioner or the applicant, and NOT by the beneficiary. Petitioner/Applicant = A person or Employer who files an immigration petition or application. Beneficiary = A person who is a recipient of an immigrant benefit being sought by someone else.
How to fill out a privacy release form?
The Privacy Release must include the following information: information is being requested (the subject of records). o Address includes the street number and name, city, state, and zip code. o A business is exempt from the date of birth and place of birth requirement.
What is a privacy release?
Under the provisions of the Privacy Act of 1974, I need to have formal authorization from you before making an inquiry to a federal agency on your behalf. This law was enacted to protect individuals from unauthorized disclosure of personal information without their consent.
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1 EXCULPATORY CLAUSE In consideration for receiving
I, (print your name). , authorize USCIS to release information contained in my USCIS records as relevant to checking my case status, and to the extent permitted
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