Response

Privacy Act Waiver

Senator Ben Ray Luján’s office is here to help New Mexicans as they navigate the federal government. We help with issues with Veterans’ Affairs, Social Security benefits, Medicare, federal taxes, immigration, passports, and other federal agency related issues.

Our staff helps with communication between constituents and federal agencies. We cannot promise you a specific outcome from an agency or referral. We will do our best to help you receive a full and fair response.

Please complete a separate form for each person seeking assistance.

The Privacy Act of 1974 (Public Law 93-579) requires your written authorization for the congressional office to contact government agencies on your behalf or discuss your case in detail. The Privacy Act authorizes the disclosure of records to congressional offices acting on behalf of constituents only when the individual has consented.

Prefix

First Name

Last Name

Address Line 1

City

State

Zip

Home Phone

Cell Phone

Work Phone

Date of Birth

Social Security Number

Other Number:

Have you spoken with Senator Luján or his staff regarding this concern? If so, who?

In addition to Senator Lujan's Office, please indicate any other congressional office or state office you have contacted:

In a few sentences, please describe what my office can assist you with.

Today's Date

Would you like to receive Senator Lujan's Email Newsletter?

Please attached the supporting documents, up to three files and no larger than 15MB a piece.

Upload FileNo file chosen

Sign using your mouse or finger...