Privacy Release Forms
By law, I am required to have a written request before any action can be taken on your behalf. You must also provide my office with a signed copy of the Privacy Act Release form or authorization of the Tax Release Information form. If your case involves medical or health-care information, my office may ask you to complete an additional release specifically authorizing access to medical information necessary to resolve your case. Please complete the appropriate form and include it with your submitted request.
Alaskans requiring assistance with an agency of the federal government are encouraged to contact one of my five state offices located in:
- Anchorage
510 L Street
Suite 600
Anchorage, AK 99501
Main: 907-271-3735
Toll Free Fax: 1-877-857-0322
Toll Free: 1-877-829-6030
- Fairbanks
101 12th Avenue
Suite #329
Fairbanks, AK 99701
Main: 907-456-0233
Fax: 907-451-7146
- Kenai
805 Frontage Road
Suite 105
Kenai, AK 99611
Main: 907-283-5808
Fax: 907-283-4363
- Ketchikan
4079 Tongass Avenue
Suite 204
Ketchikan, AK 99901
Main: 907-225-6880
Fax: 907-225-0390
- Mat-Su
851 East Westpoint Drive
Suite 307
Wasilla, AK 99654
Main: 907-376-7665
Fax: 907-376-8526
- Tax Information Release Authorization Form - Tax Information Release Authorization Form TaxInformationReleaseAuthorizationIForm.pdf (10.0 KBs)
- Privacy Act Release Form for 2013 - Privacy Act Release Form for 2013.pdf (8.0 KBs)