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Please use the format 555-123-4567
Provide a detailed description of the records you want: where possible include names, dates, locations, document titles, or case numbers. (Vague requests will delay our response time to you).

Certification of Identity

Postal Service regulation, 39 C.F.R. § 266.6, and the Privacy Act of 1974, 5 U.S.C. § 552a, require FOIA requesters to present personal identification, sufficient to identify themselves, before the OIG may release some or all of their personal information.

If you are requesting records on yourself, please complete the Proof of Identity portion, sign at the bottom.

If you are authorizing the release of records on yourself, to another person, please complete both the Proof of Identity and Authorization to Release Records to a Third Party portions and sign at the bottom

Proof of Identity

Examples of sufficient identification are a copy of a valid driver’s license, Medicare card, and/or employee identification card.

Files must be less than 4 MB.
Allowed file types: gif jpg jpeg png pdf doc docx.
Please use the format 555-123-4567

I declare under penalty of perjury under the laws of the United States of America, that the foregoing is true and correct. I understand that any falsification of this statement or obtaining any record(s) under false pretenses is punishable under the provisions of 5 USC § 522a(i)(3) as a misdemeanor and by a fine of not more than $5,000

Please Initial for signature. This is your authorization of signature.