Document DGjdG0oJJbp5pYRN93w6OKJoa

_PRIVACY ACT AUTHORIZATION pnnt name his staff to check with FTe.sieCo--k hereby authorize Congressman Pete Stauber and -Ni kczk-(c*.1 ALA .b.,1on my questions concerning: (print name of agency) PR9pLEM: c.4_.)*i f Lc.c.-k e_stt (1.0.- \or:. tte.Atc 5 tvtAes co.ry ..3,_,L -its,,k c..)vV1- __ A-it RESULTS EXPECTED: --1..._ C3--)A tr-- c..k.ko.s... -14/--e. (--- exi-i- --c441--k-1me____ , to<.,, t t,36%3 -- - --A- --IN -C-ca_aike k ----Cte-'e-- Zt.. h-ca_c,C-- --c-ult-cs_ie-- -- -NA LAS zs,-i-ast--- ,(c..... , $4csk, -;a4 o(N`Ltr+V(J., ' 4)-A k P _04.1,,A M (b)(6) NAME: (b)(6) ADDRESS: mr, CITY:, TELEPHONE NUMBER: (H) - (b)(6) EMAIL: STATE.Mid ZIP CODE: b)(6) b)(6) b)(6) C DOB (b)(6) LOAN#, SS#, VA#, A# or other relevant type case number: I certify, under penalty of perjury, that 1) I provided or authorized all of the 'nformation in this privacy release and any document submitted with it; 2) I reviewed and understand all of the information contained in my privacy releua and.submitted with it and 11 211 of this information 1s.complete, true, and correct. (b)(6) SIGNATURE: RETURN THIS CONGRESSMAN PET STAUBER 5094 Miller Trunk Highway. Suite 900 Hermantown, MN 55811 PHONE (218-355-0280) Please include a detailed history of the problem and copies of all correspondence with the agency. Sierra Club v. Dept. of Transp. - 3:25-cv-06221 SC_EVERSPLIT0019186