Assembly Member Khaleel M. Anderson District 31 - Constituent Intake Form

If you have a community issue that you think my office may be able to help you resolve, please complete this form today!

Complete all fields of the form below and a staffer from my office will respond to follow up within three to five business days (excluding holidays). If you have additional questions, give us a call at 718-327-1845.

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First Name
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Last Name
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Date of Birth
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Zip Code *
Phone Number *
Email *
Type of Contact *
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Please describe the issue you have.
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