Authorization for the Release of Records to Another Individual

In general, under the provisions of the FOIA and Privacy Act, access to information about private individuals cannot be given to unauthorized third parties without the individual’s written consent. If you provide authorization, your request will be processed with the greatest possible access. If you do not or are unable to provide authorization, your request will be processed, but release of records will be severely restricted to protect the privacy of another individual.

What Is A Proper Authorization? (22 C.F.R. 171.11(n))

• Should be in writing
• Should be on plain paper or your letterhead (NOTE: do not use forms from other agencies, as they do not authorize the Department of State to release documents)
• Should authorize the Department of State to release documents concerning the individual to you
• Should be signed by the individuals who the documents are about
• Should contain either:
  1. A notarization from a notary public - which has the signature of the individual who is the subject of the records, the signature and seal of the notary, and be dated within six months of the request, or
  2. A statement from the individual who is the subject of the records saying: “I declare, certify, verify or state that, under penalty of perjury under the laws of the United States of America, the foregoing is true and correct.” This statement should be signed by the individual who the records are about, and be dated within six months of the date of the request.

Submitting the Authorization

he authorization(s) may be forwarded to us at: Office of Information Programs and Services, ATTN: A/GIS/IPS/RL, U.S. Department of State, SA-2, Washington, DC 20522-8100, or may be faxed to us at 202-485-1669.. Please be sure to refer to your Case Control Number in your correspondence.

To ensure you receive the greatest possible access to documents, authorizations for all persons you are requesting records about should be received by this office within 30 calendar days of the date of this letter. If you are unable to provide an authorization, please notify us in writing. If proper authorizations are not received within 30 calendar days of the date of our letter, your request will be processed accordingly and the release of documents will be severely restricted.

Documents about a Deceased Person

For deceased individuals, unless the death has been widely reported, please provide proof of death, e.g., a newspaper obituary or a copy of a death certificate, or advise us that none will be forthcoming.

PLEASE NOTE: Please submit a separate authorization for each person you are requesting records about. For example, in cases involving an immigrant visa petitioner and one or more beneficiaries, please submit authorizations from the petitioner and all beneficiaries.

An Example of a Proper Authorization

RE: Case Control Number ______________________________

I, _____________________________, authorize the Department of State to release all records about me to ____________________________. I declare, certify, verify or state that, under penalty of perjury under the laws of the United States of America, the foregoing is true and correct.