Privacy Program Resources

Electronic Privacy Act Request Consent for Disclosure of Records

Consent for disclosure of records protected under the Privacy Act

This form may be used to provide consent and authorize the National Archives and Records Administration (NARA) to disclose NARA operational records about you to another person or entity or to make a first-party request under the Privacy Act for operational records. Please provide the information requested below and submit. Once your inquiry is received and processed, an email will be sent to the address you provide. Please note further information may be requested.

This form cannot be used to make a Freedom of Information Act request, to request archival records from the holdings of the National Archives, or to request information, including Official Military Personnel Folders, from the National Personnel Records Center.

This form may be used if you are:

  • Providing consent and authorizing NARA to disclose your records to another person or entity
  • A parent consenting to and authorizing the disclosure of the records of a minor
  • A legal guardian consenting to and authorizing disclosure of the records of an incompetent

If you have any questions, please contact the NARA’s FOIA Office at privacy@nara.gov or at 301-837-3642.  

Information used to confirm and authenticate who you are

Please provide the following information to assist the NARA in verifying your identity:

Required

  • Full name
  • Electronically signed statement (at the bottom of this form) that affirms your identity and the fact that you understand penalties associated with requesting information under false pretenses

For requests by parent or legal guardian

If you are the parent consenting to and authorizing disclosure of the records of a minor or the legal guardian consenting to and authorizing disclosure of the records of an incompetent, you will be required to provide adequate proof of your legal relationship before action will be taken on any request. Proof of your legal relationship may include a birth certificate or adoption papers. If you have any questions, please contact the NARA’s FOIA Office at privacy@nara.gov or at 301-837-3642. The term guardian means the legal guardian of any individual who has been declared to be incompetent due to physical or mental incapacity or age by a court of competent jurisdiction.

Information required to locate the records

This information is required for the NARA to be able to match the individual's information provided in this request with the record that pertains to that individual.

Additional information that might assist in locating the records

This enables the NARA to locate the system of records containing the record(s) with a reasonable amount of effort.

Any additional information (optional)

This may include when the record was created, maiden name, dates of employment, account information, etc.

Contact Information

Please provide your contact information so that we can correspond with you regarding the request

Requestor contact information

 

Recipient contact information

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