Congressman Tom Marino

Representing the 10th District of Pennsylvania

Agency Help

If you can't get an answer from a federal agency in a timely fashion, or if you feel you have been treated unfairly, our office may be able to help resolve a problem or get you the information you need. While we cannot guarantee you a favorable outcome, we will do our best to help you receive a fair and timely response to your problem.

Residents of the 10th Congressional District of Pennsylvania can contact us for assistance in dealing with Federal agencies. In order to better serve you, this form will generate a printable page that you should sign and mail to our office.

Please include all pertinent information and claim numbers in your correspondence—such as:

Your Social Security number for a case involving Social Security;
VA claim number for a case with Department of Veterans Affairs;
Taxpayer identification number (Social Security number, if individual) for an Internal Revenue Service problem, etc.;
Your address, home phone number and daytime phone number (if different than home) so that we can obtain any additional information from you that might be necessary;
Copies of any related documents or correspondence that you may have from the agency involved

Authorization Form

This is a three-step process. Step one is to fill in the form with the required data, then click the “Generate Request for Review” button at the bottom of the page.

I certify, under the penalty of perjury, that I provided or authorized all of the information in this privacy release. That I reviewed and understand all information contained in my privacy release and submitted with it and that all information is complete, true and correct. I, hereby authorize Congressman Tom Marino and his staff to work on my behalf with any federal agency relevant to the matter described below, to receive and review any information contained in my file and, if necessary, to forward any pertinent correspondence sent by me regarding this matter.

We must have your signature to proceed with this type of request

Signature: ___________________________________

Date:_______________________________________

marks required fields of data.

Your Information

Full Name:

Agency Involved:

Agency case number(s) or "None")

Social Security Number:

Branch of Service: (If Applicable)

Military Rank: (If Applicable)

Date of Birth:

Street Address:

City:

State:

ZIP Code:

Email:

Telephone

Phone Number / Type:

What are these options?
This is to help the constituents that are hard of hearing or use a video phone alert us to that fact so we can use the proper technology when we need to call them. The default option “Voice” is a normal audible telephone.

Please Explain the Problem:

Print, and then mail or fax your request to:

Office of Congressman Thomas Marino
Attn: Jacqueline Bell
c/o Williamsport Constituent Service Center
1020 Commerce Park Drive, Suite 1A
Williamsport PA 17701
Phone: (570) 322-3961
Fax: (570) 322-3965

Print This Form

Use the Generate Request for Review button to produce the document to authorize our office to help you. Print, sign, and mail, fax, or hand deliver it to the address shown on the document. Please include any other documents or material that you think would help our office help you.