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Casework File

If you would like to initiate a casework file with my office, please fill out the form below.  Be sure to include the three following items:

  1. A clear explanation of the issue or problem you are facing.
  2. A detailed description of any actions already taken or offices you have spoken with.
  3. A short description of any additional relevant documents relating to your issue or problem.  We will contact you with additional instructions of where to send these documents.

First Name (required)

Last Name (required)

Address

City

State

Zip

Your Email (required)

Phone Number

Problem or Issue

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