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Federal Agency Help
Thank you for filling out this help request form. Please print and sign this form below. To return
the form you have two options:
1. Mail the form to Senator Gardner's office in Denver:
Your Information
Name:
Ms. Heather Jean Welk
Address:
2101 w Cornell ave
Englewood, CO 80110
Email: Phone Number:
welk944@gmail.com 7204143407
Additional Information
Your Request
I am aware that provisions of the Privacy Act of 1974 (Public Law 93-579) may prohibit the
release of information in covered agency files without my consent. I hereby consent to the
release of such information to the Office of United States Senator Cory Gardner and/or
members of his staff in connection with my case or claim.