Step 1
Please read about what kind of assistance our office can offer to constituents.

Ensure that the person requesting assistance lives in the Fifth District of Minnesota.

Please read our privacy policy that
protects you.

Step 2
Fill out this form as best you can and press submit to e-mail it to
Congressman Ellison’s Office.

If you prefer to not send your Social Security Number electronically, do not enter it in the form, instead write it by hand on the release form that you send in.

Step 3
Please print out the privacy release form on the next page and have the person requesting assistance sign it.

This signed form must be faxed, e-mailed or mailed to our Minneapolis office before we can begin helping you.