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  1. U.S. Senator Rick Scott Privacy Act Consent Form. By providing the information below and signing this form, I hereby authorize (Agency Name) to furnish Senator Rick Scott’s Office information pertaining to my claim or request. This authorization is in accordance with the Privacy Act of 1974 (Public Law 93-579).

  2. Privacy Act Consent Form By providing the information below and signing this form, I hereby authorize (Agency Name) to furnish Senator Rick Scott’s Office information pertaining to my claim or request.

  3. Privacy Act Consent Form — U.S. Citizenship & Immigration Services. In accordance with the provisions of The Privacy Act of 1974 (5 U.S.C. § 552a ), your written consent is required so that we may contact a federal agency on your behalf.

  4. Privacy Act Consent Form — U.S. Department of State (Passports) In accordance with the provisions of The Privacy Act of 1974 (5 U.S.C. § 552a ), your written consent is required so that we may contact a federal agency on your behalf.

  5. Privacy Act Consent Form — U.S. Citizenship & Immigration Services. In accordance with the provisions of The Privacy Act of 1974 (Public Law 93-579), your writen consent is required so that we may contact a federal agency on your behalf.

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