Mobile Menu - OpenMobile Menu - Closed

Authorization Form For United States Citizenship and Immigration Services (USCIS)

Download the USCIS casework form for the Office of Congressmember Karen Bass here.

To submit a casework request form for an agency other than USCIS, click here.

This is a three-step process.  Step one is to fill in the form with the required data, then review your answers.  Once reviewed, print and mail, fax, or hand deliver the document to our office.  The address and fax number are on the generated page.

In accordance with the Privacy Act of 1974, I give Congresswoman Karen Bass authority to act on my behalf.

  marks required fields of data.

Your Information
Telephone

What are these options?
This is to help the constituents that are hard of hearing or use a video phone alert us to that fact so we can use the proper technology when we need to call them. The default option "Voice" is a normal audible telephone.