How to Write a Privacy Act Request

When you make a request for notification of or access to records, it should:

  1. Be made in writing and signed by the person making the request, who must be the individual about whom the record is maintained;
  2. State that it is made pursuant to the Privacy Act, 5 U.S.C. 552a, and be marked "Privacy Act Request" on the request and on the envelope;
  3. Give the name of the system of records to which access is sought (see "System of Record Notices"); A listing of the more recent Privacy Act documents appearing in the Federal Register can be found  under "System of Record Notices".
  4. Provide enough information (i.e., the nature of the record sought, the date of the record or the period in which the record was compiled) to enable us to locate the record with a reasonable amount of effort;
  5. State that you are a citizen of the United States or an alien lawfully admitted for permanent residence in the United States;
  6. Provide verification of your identity (see below);
  7. Be sent to the address indicated for the requested system of records, as specified in "System of Record Notices";
  8. State whether you wish to inspect the records or desire to have a copy made;
    Give a firm agreement to pay the fees for duplication that might be incurred; and
  9. If necessary, provide written consent for release of the information to your authorized representative (see below).


Individuals may not get information about someone else under the Privacy Act. If you want the Department to release information about you to someone else, such as your attorney or other authorized representative, you will need to provide written consent for the release of the information. The written authorization must contain:

  1. A description of the record which may be disclosed;
  2. The name of the person, firm, or agency to which the record will be disclosed;
  3. A statement that the Department is authorized to disclose the record;
  4. Your signature and the date; and
  5. Verification of your identity.

Verification of Identity

You must verify your identity before action will be taken on any request. This can be done by providing a copy of a driver's license bearing your signature; or by providing a signed and dated statement that you understand the penalties provided in 5 U.S.C. 552a(i)(3) for requesting access to records under false pretenses, and the statement is subscribed by you as true and correct under penalty of perjury pursuant to 28 U.S.C. 1746.


Fees may be charged only for the cost of duplication, without regard to whether the request was processed under the Privacy Act, the Freedom of Information Act, or both. The first l00 pages will be provided without charge.

Where to Send Your Privacy Act Request

Bureau FOIA/PA Offices