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Congressional Acknowledgements | Representative Kweisi Mfume
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" class="img-fluid"></div></div></div><p><span><span>Congressman Kweisi Mfume wants to provide acknowledgements to honor his constituents, and we want to make the process as accurate and efficient as possible. Pertinent information is required to fulfill requests. Please note that because our office receives numerous requests daily, we ask that you give us a minimum of two weeks’ notice to prepare your acknowledgement before your scheduled event. In some instances, due to the overwhelming volume of requests received, there is no guarantee that your acknowledgment will be completed by the date of your event</span></span></p><p>If you would like to request a Congressional Commendation for someone residing in the 7th Congressional District, please complete and submit the form below.</p></div><div class="webform__webform"><form class="webform-submission-form webform-submission-add-form webform-submission-webform-221-form webform-submission-webform-221-add-form webform-submission-webform-221-node-34-form webform-submission-webform-221-node-34-add-form js-webform-unsaved js-webform-disable-autosubmit js-webform-details-toggle webform-details-toggle" data-drupal-selector="webform-submission-webform-221-node-34-add-form" action="/services/congressional-acknowledgements" method="post" id="webform-submission-webform-221-node-34-add-form" accept-charset="UTF-8"><div class="webform-wizard-pages-links js-webform-wizard-pages-links js-form-wrapper form-wrapper" data-wizard-progress-link="true" data-drupal-selector="edit-pages" id="edit-pages"></div><div class="webform-required"><span class="form-required"></span>Indicates required field </div><div data-webform-key="page_1" data-drupal-selector="edit-page-1" id="edit-page-1--2" class="js-form-wrapper form-wrapper"><div id="edit-privacy-notice" class="js-form-item form-item js-form-type-processed-text form-item- js-form-item- form-group"><label class="visually-hidden" for="edit-privacy-notice">Privacy Notice</label><p></p></div><fieldset data-drupal-selector="edit-fieldset-contact" id="edit-fieldset-contact" class="js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper card mb-3"><legend class="card-header"><span class="fieldset-legend m-0">Requestor Contact Information</span></legend><div class="card-body fieldset-wrapper"><div class="js-form-item form-item js-form-type-select form-item-honorific-2 js-form-item-honorific-2 form-group"><label for="edit-honorific-2" class="js-form-required form-required">Prefix:</label><select data-webform-required-error="Please select an option from the "Prefix" list." data-drupal-selector="edit-honorific-2" id="edit-honorific-2" name="honorific_2" class="form-select required custom-select" required="required"><option value="" selected="selected">- Select -</option><option value="Ms.">Ms.</option><option value="Miss.">Miss.</option><option value="Mrs.">Mrs.</option><option value="Mr.">Mr.</option><option value="Mr. and Mrs.">Mr. and Mrs.</option><option value="Rev.">Rev.</option><option value="Dr.">Dr.</option><option value="The Honorable">The Honorable</option><option value="Rabbi">Rabbi</option></select></div><div class="js-form-item form-item js-form-type-textfield form-item-first-name-2 js-form-item-first-name-2 form-group"><label for="edit-first-name-2" class="js-form-required form-required">First Name: </label><input data-webform-required-error="Please provide "First Name"." data-drupal-selector="edit-first-name-2" type="text" id="edit-first-name-2" name="first_name_2" value="" size="60" maxlength="255" class="required form-control" required="required" /></div><div class="js-form-item form-item js-form-type-textfield form-item-mi-2 js-form-item-mi-2 form-group"><label for="edit-mi-2">MI: </label><input data-drupal-selector="edit-mi-2" type="text" id="edit-mi-2" name="mi_2" value="" size="60" maxlength="255" class="form-control" /></div><div class="js-form-item form-item js-form-type-textfield form-item-last-name-2 js-form-item-last-name-2 form-group"><label for="edit-last-name-2" class="js-form-required form-required">Last Name: </label><input data-webform-required-error="Please provide "Last Name"." data-drupal-selector="edit-last-name-2" type="text" id="edit-last-name-2" name="last_name_2" value="" size="60" maxlength="255" class="required form-control" required="required" /></div><div class="js-form-item form-item js-form-type-select form-item-suffix-2 js-form-item-suffix-2 form-group"><label for="edit-suffix-2">Suffix:</label><select data-drupal-selector="edit-suffix-2" id="edit-suffix-2" name="suffix_2" class="form-select custom-select"><option value="" selected="selected">- None -</option><option value="2nd">2nd</option><option value="3rd">3rd</option><option value="4th">4th</option><option value="II">II</option><option value="III">III</option><option value="IV">IV</option><option value="Jr.">Jr.</option><option value="Sr.">Sr.</option><option value="M.D.">M.D.</option><option value="PH.D.">PH.D.</option><option value="and Family">and Family</option></select></div><div data-drupal-selector="edit-address" id="edit-address--wrapper" class="webform-address--wrapper fieldgroup form-composite js-form-wrapper form-wrapper"><div class="js-form-item form-item js-form-type-textfield form-item-address-address js-form-item-address-address form-group"><label for="edit-address-address" class="js-form-required form-required">Address</label><input data-webform-required-error="Please provide a street address for "Address"." data-drupal-selector="edit-address-address" type="text" id="edit-address-address" name="address[address]" value="" size="60" maxlength="255" class="required form-control" required="required" /></div><div class="js-form-item form-item js-form-type-textfield form-item-address-address-2 js-form-item-address-address-2 form-group"><label for="edit-address-address-2">Address 2</label><input data-drupal-selector="edit-address-address-2" type="text" id="edit-address-address-2" name="address[address_2]" value="" size="60" maxlength="255" class="form-control" /></div><div class="js-form-item form-item js-form-type-textfield form-item-address-city js-form-item-address-city form-group"><label for="edit-address-city" class="js-form-required form-required">City</label><input data-webform-required-error="Please provide the "City" for the specified street address." data-drupal-selector="edit-address-city" type="text" id="edit-address-city" name="address[city]" value="" size="60" maxlength="255" class="required form-control" required="required" /></div><div class="js-form-item form-item js-form-type-select form-item-address-state-province js-form-item-address-state-province form-group"><label for="edit-address-state-province" class="js-form-required form-required">State</label><select data-webform-required-error="Please select the "State" for the specified street address." data-drupal-selector="edit-address-state-province" id="edit-address-state-province" name="address[state_province]" class="form-select required custom-select" required="required"><option value="">- Select -</option><option value="Alabama">Alabama</option><option value="Alaska">Alaska</option><option value="American Samoa">American Samoa</option><option value="Arizona">Arizona</option><option value="Arkansas">Arkansas</option><option value="Armed Forces (Canada, Europe, Africa, or Middle East)">Armed Forces (Canada, Europe, Africa, or Middle East)</option><option value="Armed Forces Americas">Armed Forces Americas</option><option value="Armed Forces Pacific">Armed Forces Pacific</option><option value="California">California</option><option value="Colorado">Colorado</option><option value="Connecticut">Connecticut</option><option value="Delaware">Delaware</option><option value="District of Columbia">District of Columbia</option><option value="Federated States of Micronesia">Federated States of Micronesia</option><option value="Florida">Florida</option><option value="Georgia">Georgia</option><option value="Guam">Guam</option><option value="Hawaii">Hawaii</option><option value="Idaho">Idaho</option><option value="Illinois">Illinois</option><option value="Indiana">Indiana</option><option value="Iowa">Iowa</option><option value="Kansas">Kansas</option><option value="Kentucky">Kentucky</option><option value="Louisiana">Louisiana</option><option value="Maine">Maine</option><option value="Marshall Islands">Marshall Islands</option><option value="Maryland" selected="selected">Maryland</option><option value="Massachusetts">Massachusetts</option><option value="Michigan">Michigan</option><option value="Minnesota">Minnesota</option><option value="Mississippi">Mississippi</option><option value="Missouri">Missouri</option><option value="Montana">Montana</option><option value="Nebraska">Nebraska</option><option value="Nevada">Nevada</option><option value="New Hampshire">New Hampshire</option><option value="New Jersey">New Jersey</option><option value="New Mexico">New Mexico</option><option value="New York">New York</option><option value="North Carolina">North Carolina</option><option value="North Dakota">North Dakota</option><option value="Northern Mariana Islands">Northern Mariana Islands</option><option value="Ohio">Ohio</option><option value="Oklahoma">Oklahoma</option><option value="Oregon">Oregon</option><option value="Palau">Palau</option><option value="Pennsylvania">Pennsylvania</option><option value="Puerto Rico">Puerto Rico</option><option value="Rhode Island">Rhode Island</option><option value="South Carolina">South Carolina</option><option value="South Dakota">South Dakota</option><option value="Tennessee">Tennessee</option><option value="Texas">Texas</option><option value="Utah">Utah</option><option value="Vermont">Vermont</option><option value="Virgin Islands">Virgin Islands</option><option value="Virginia">Virginia</option><option value="Washington">Washington</option><option value="West Virginia">West Virginia</option><option value="Wisconsin">Wisconsin</option><option value="Wyoming">Wyoming</option></select></div><div class="js-form-item form-item js-form-type-textfield form-item-address-postal-code js-form-item-address-postal-code form-group"><label for="edit-address-postal-code" class="js-form-required form-required">ZIP Code</label><input data-webform-required-error="Please provide the "ZIP Code" for the specified street address." data-drupal-selector="edit-address-postal-code" type="text" id="edit-address-postal-code" name="address[postal_code]" value="" size="60" maxlength="255" class="required form-control" required="required" /></div></div><div class="js-form-item form-item js-form-type-tel form-item-number-18 js-form-item-number-18 form-group"><label for="edit-number-18" class="js-form-required form-required">Phone Number</label><input data-webform-required-error="Please provide a valid number for "Phone Number"." pattern="\d{3}-?\d{3}-?\d{4}" data-webform-pattern-error="Please match the requested telephone number format (###-###-####) for "Phone Number"." data-drupal-selector="edit-number-18" type="tel" id="edit-number-18" name="number_18" value="" size="30" maxlength="128" class="form-tel required form-control" required="required" /></div><div class="js-form-item form-item js-form-type-email form-item-email-9 js-form-item-email-9 form-group"><label for="edit-email-9" class="js-form-required form-required">Email:</label><input data-webform-required-error="Please provide a valid email address for "Email"." pattern="^(?:[\w\!\#\$\%\&\'\*\+\-\/\=\?\^\`\{\|\}\~]+\.)*[\w\!\#\$\%\&\'\*\+\-\/\=\?\^\`\{\|\}\~]+@(?:(?:(?:[a-zA-Z0-9_](?:[a-zA-Z0-9_\-](?!\.)){0,61}[a-zA-Z0-9_-]?\.)+[a-zA-Z0-9_](?:[a-zA-Z0-9_\-](?!$)){0,61}[a-zA-Z0-9_]?)|(?:\[(?:(?:[01]?\d{1,2}|2[0-4]\d|25[0-5])\.){3}(?:[01]?\d{1,2}|2[0-4]\d|25[0-5])\]))$" data-webform-pattern-error="Please enter a valid email address. The email address you entered for "Email" does not match the standard format of abc@example.com." data-drupal-selector="edit-email-9" type="email" id="edit-email-9" name="email_9" value="" size="20" maxlength="254" class="form-email required form-control" required="required" /></div></div></fieldset><fieldset data-drupal-selector="edit-acknowledgement-type" id="edit-acknowledgement-type" class="js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper card mb-3"><legend class="card-header"><span class="fieldset-legend m-0">Acknowledgement</span></legend><div class="card-body fieldset-wrapper"><fieldset data-drupal-selector="edit-acknowledgement-type-select" class="js-webform-select-other webform-select-other webform-select-other--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-webform-select-other webform-type-webform-select-other js-form-item form-item js-form-wrapper form-wrapper card mb-3" id="edit-acknowledgement-type-select"><legend class="card-header"><span class="fieldset-legend m-0">Acknowledgement Type</span></legend><div class="card-body fieldset-wrapper"><div class="js-form-item form-item js-form-type-select form-item-acknowledgement-type-select-select js-form-item-acknowledgement-type-select-select form-no-label form-group"><label for="edit-acknowledgement-type-select-select" class="visually-hidden">Acknowledgement Type</label><select data-drupal-selector="edit-acknowledgement-type-select-select" id="edit-acknowledgement-type-select-select" name="acknowledgement_type_select[select]" class="form-select custom-select"><option value="" selected="selected">- None -</option><option value="Condolence Letter">Condolence Letter</option><option value="Birthday (65, 70, 75, 80+ years old)">Birthday (65, 70, 75, 80+ years old)</option><option value="Employment Anniversary (20, 25, 30+ years)">Employment Anniversary (20, 25, 30+ years)</option><option value="Wedding Anniversary (20, 25, 30, 35, 40, 45, 50+ years)">Wedding Anniversary (20, 25, 30, 35, 40, 45, 50+ years)</option><option value="Retirement from Federal/Government Service (20, 25, 30+ years)">Retirement from Federal/Government Service (20, 25, 30+ years)</option><option value="Citizenship">Citizenship</option><option value="Eagle Scout">Eagle Scout</option><option value="Gold Star">Gold Star</option><option value="_other_">Other Achievements or Public Distinctions</option></select></div><div class="js-webform-select-other-input webform-select-other-input js-form-item form-item js-form-type-textfield form-item-acknowledgement-type-select-other js-form-item-acknowledgement-type-select-other form-no-label form-group"><label for="edit-acknowledgement-type-select-other" class="visually-hidden">Other Achievements or Public Distinctions</label><input data-drupal-selector="edit-acknowledgement-type-select-other" type="text" id="edit-acknowledgement-type-select-other" name="acknowledgement_type_select[other]" value="" size="60" maxlength="255" placeholder="Other Achievements or Public Distinctions" class="form-control" /></div></div></fieldset><div class="js-form-item form-item js-form-type-textfield form-item-other-acknowledgements js-form-item-other-acknowledgements form-group"><label for="edit-other-acknowledgements">Other Acknowledgements</label><input data-drupal-selector="edit-other-acknowledgements" type="text" id="edit-other-acknowledgements" name="other_acknowledgements" value="" size="60" maxlength="255" class="form-control" /></div><fieldset data-drupal-selector="edit-exact-date-of-occasion" id="edit-exact-date-of-occasion" class="js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper card mb-3"><legend class="card-header"><span class="fieldset-legend m-0">Exact Date of Occasion:</span></legend><div class="card-body fieldset-wrapper"><div class="evo-form--inline js-form-item form-item js-form-type-select form-item-occasion-month js-form-item-occasion-month form-group"><label for="edit-occasion-month">Month</label><select data-drupal-selector="edit-occasion-month" id="edit-occasion-month" name="occasion_month" class="form-select custom-select"><option value="" selected="selected">MM</option><option value="01">Jan</option><option value="02">Feb</option><option value="03">Mar</option><option value="04">Apr</option><option value="05">May</option><option value="06">June</option><option value="07">July</option><option value="08">Aug</option><option value="09">Sep</option><option value="10">Oct</option><option value="11">Nov</option><option value="12">Dec</option></select></div><div class="evo-form--inline js-form-item form-item js-form-type-select form-item-occasion-day js-form-item-occasion-day form-group"><label for="edit-occasion-day">Day</label><select data-drupal-selector="edit-occasion-day" id="edit-occasion-day" name="occasion_day" class="form-select custom-select"><option value="" selected="selected">DD</option><option value="01">01</option><option value="02">02</option><option value="03">03</option><option value="04">04</option><option value="05">05</option><option value="06">06</option><option value="07">07</option><option value="08">08</option><option value="09">09</option><option value="10">10</option><option value="11">11</option><option value="12">12</option><option value="13">13</option><option value="14">14</option><option value="15">15</option><option value="16">16</option><option value="17">17</option><option value="18">18</option><option value="19">19</option><option value="20">20</option><option value="21">21</option><option value="22">22</option><option value="23">23</option><option value="24">24</option><option value="25">25</option><option value="26">26</option><option value="27">27</option><option value="28">28</option><option value="29">29</option><option value="30">30</option><option value="31">31</option></select></div><div class="evo-form--inline js-form-item form-item js-form-type-textfield form-item-occasion-year js-form-item-occasion-year form-group"><label for="edit-occasion-year">Year</label><input minlength="4" data-drupal-selector="edit-occasion-year" type="text" id="edit-occasion-year" name="occasion_year" value="" size="4" maxlength="4" placeholder="YYYY" class="form-control" /></div></div></fieldset><div id="edit-processed-text-01" class="js-form-item form-item js-form-type-processed-text form-item- js-form-item- form-no-label form-group"><p><span><span><span>Please provide specific information about the person/organization you are requesting this acknowledgement for in four or more sentences. To assist with personalizing the acknowledgement please provide us with community service activities, career achievements, faith-based affiliations, leadership positions, accomplishments, hobbies, and recreational activities. </span></span></span></p></div><div class="js-form-item form-item js-form-type-textarea form-item-recipient-should-receive-this-acknowledge js-form-item-recipient-should-receive-this-acknowledge form-group"><label for="edit-recipient-should-receive-this-acknowledge">Why do you believe the recipient should receive this acknowledgement?</label><textarea data-drupal-selector="edit-recipient-should-receive-this-acknowledge" id="edit-recipient-should-receive-this-acknowledge" name="recipient_should_receive_this_acknowledge" rows="5" cols="60" class="form-textarea form-control"></textarea></div></div></fieldset><fieldset data-drupal-selector="edit-fieldset-honoree" id="edit-fieldset-honoree" class="js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper card mb-3"><legend class="card-header"><span class="fieldset-legend m-0">Honoree’s/Organization’s Information</span></legend><div class="card-body fieldset-wrapper"><div class="js-form-item form-item js-form-type-textfield form-item-first-name-h-23 js-form-item-first-name-h-23 form-group"><label for="edit-first-name-h-23" class="js-form-required form-required">First Name/Organization Name</label><input data-webform-required-error="Please provide "First Name of Honoree"." data-drupal-selector="edit-first-name-h-23" type="text" id="edit-first-name-h-23" name="first_name_h_23" value="" size="60" maxlength="255" class="required form-control" required="required" /></div><div class="js-form-item form-item js-form-type-textfield form-item-last-name-h-23 js-form-item-last-name-h-23 form-group"><label for="edit-last-name-h-23" class="js-form-required form-required">Last Name</label><input data-webform-required-error="Please provide "Last Name of Honoree"." data-drupal-selector="edit-last-name-h-23" type="text" id="edit-last-name-h-23" name="last_name_h_23" value="" size="60" maxlength="255" class="required form-control" required="required" /></div><div class="js-form-item form-item js-form-type-webform-address form-item-address-of-honoree js-form-item-address-of-honoree form-no-label form-group"><div class="js-form-item form-item js-form-type-textfield form-item-address-of-honoree-address js-form-item-address-of-honoree-address form-group"><label for="edit-address-of-honoree-address" class="js-form-required form-required">Address</label><input data-webform-required-error="Please provide a street address for "Address"." data-drupal-selector="edit-address-of-honoree-address" type="text" id="edit-address-of-honoree-address" name="address_of_honoree[address]" value="" size="60" maxlength="255" class="required form-control" required="required" /></div><div class="js-form-item form-item js-form-type-textfield form-item-address-of-honoree-address-2 js-form-item-address-of-honoree-address-2 form-group"><label for="edit-address-of-honoree-address-2">Address 2</label><input data-drupal-selector="edit-address-of-honoree-address-2" type="text" id="edit-address-of-honoree-address-2" name="address_of_honoree[address_2]" value="" size="60" maxlength="255" class="form-control" /></div><div class="js-form-item form-item js-form-type-textfield form-item-address-of-honoree-city js-form-item-address-of-honoree-city form-group"><label for="edit-address-of-honoree-city" class="js-form-required form-required">City</label><input data-webform-required-error="Please provide the "City" for the specified street address." data-drupal-selector="edit-address-of-honoree-city" type="text" id="edit-address-of-honoree-city" name="address_of_honoree[city]" value="" size="60" maxlength="255" class="required form-control" required="required" /></div><div class="js-form-item form-item js-form-type-select form-item-address-of-honoree-state-province js-form-item-address-of-honoree-state-province form-group"><label for="edit-address-of-honoree-state-province" class="js-form-required form-required">State</label><select data-webform-required-error="Please select the "State" for the specified street address." data-drupal-selector="edit-address-of-honoree-state-province" id="edit-address-of-honoree-state-province" name="address_of_honoree[state_province]" class="form-select required custom-select" required="required"><option value="" selected="selected">- Select -</option><option value="Alabama">Alabama</option><option value="Alaska">Alaska</option><option value="American Samoa">American Samoa</option><option value="Arizona">Arizona</option><option value="Arkansas">Arkansas</option><option value="Armed Forces (Canada, Europe, Africa, or Middle East)">Armed Forces (Canada, Europe, Africa, or Middle East)</option><option value="Armed Forces Americas">Armed Forces Americas</option><option value="Armed Forces Pacific">Armed Forces Pacific</option><option value="California">California</option><option value="Colorado">Colorado</option><option value="Connecticut">Connecticut</option><option value="Delaware">Delaware</option><option value="District of Columbia">District of Columbia</option><option value="Federated States of Micronesia">Federated States of Micronesia</option><option value="Florida">Florida</option><option value="Georgia">Georgia</option><option value="Guam">Guam</option><option value="Hawaii">Hawaii</option><option value="Idaho">Idaho</option><option value="Illinois">Illinois</option><option value="Indiana">Indiana</option><option value="Iowa">Iowa</option><option value="Kansas">Kansas</option><option value="Kentucky">Kentucky</option><option value="Louisiana">Louisiana</option><option value="Maine">Maine</option><option value="Marshall Islands">Marshall Islands</option><option value="Maryland">Maryland</option><option value="Massachusetts">Massachusetts</option><option value="Michigan">Michigan</option><option value="Minnesota">Minnesota</option><option value="Mississippi">Mississippi</option><option value="Missouri">Missouri</option><option value="Montana">Montana</option><option value="Nebraska">Nebraska</option><option value="Nevada">Nevada</option><option value="New Hampshire">New Hampshire</option><option value="New Jersey">New Jersey</option><option value="New Mexico">New Mexico</option><option value="New York">New York</option><option value="North Carolina">North Carolina</option><option value="North Dakota">North Dakota</option><option value="Northern Mariana Islands">Northern Mariana Islands</option><option value="Ohio">Ohio</option><option value="Oklahoma">Oklahoma</option><option value="Oregon">Oregon</option><option value="Palau">Palau</option><option value="Pennsylvania">Pennsylvania</option><option value="Puerto Rico">Puerto Rico</option><option value="Rhode Island">Rhode Island</option><option value="South Carolina">South Carolina</option><option value="South Dakota">South Dakota</option><option value="Tennessee">Tennessee</option><option value="Texas">Texas</option><option value="Utah">Utah</option><option value="Vermont">Vermont</option><option value="Virgin Islands">Virgin Islands</option><option value="Virginia">Virginia</option><option value="Washington">Washington</option><option value="West Virginia">West Virginia</option><option value="Wisconsin">Wisconsin</option><option value="Wyoming">Wyoming</option></select></div><div class="js-form-item form-item js-form-type-textfield form-item-address-of-honoree-postal-code js-form-item-address-of-honoree-postal-code form-group"><label for="edit-address-of-honoree-postal-code" class="js-form-required form-required">ZIP</label><input data-webform-required-error="Please provide the "ZIP" for the specified street address." data-drupal-selector="edit-address-of-honoree-postal-code" type="text" id="edit-address-of-honoree-postal-code" name="address_of_honoree[postal_code]" value="" size="60" maxlength="255" class="required form-control" required="required" /></div></div><div id="edit-processed-text-02" class="js-form-item form-item js-form-type-processed-text form-item- js-form-item- form-no-label form-group"><p><strong><span><span><span>You will be contacted by a staff member once the acknowledgement is completed. The final acknowledgement document will be mailed. Please provide the address you would like the document mailed to. </span></span></span></strong></p></div><div class="js-form-item form-item js-form-type-webform-address form-item-acknowledgement-mailing-addess js-form-item-acknowledgement-mailing-addess form-no-label form-group"><label for="edit-acknowledgement-mailing-addess" class="visually-hidden js-form-required form-required">You will be contacted by a staff member once the acknowledgement is completed. The final acknowledgement document will be mailed. Please provide the address you would like the document mailed to. </label><div class="js-form-item form-item js-form-type-textfield form-item-acknowledgement-mailing-addess-address js-form-item-acknowledgement-mailing-addess-address form-group"><label for="edit-acknowledgement-mailing-addess-address" class="js-form-required form-required">Address</label><input data-webform-required-error="Please provide a street address for "Address"." data-drupal-selector="edit-acknowledgement-mailing-addess-address" type="text" id="edit-acknowledgement-mailing-addess-address" name="acknowledgement_mailing_addess[address]" value="" size="60" maxlength="255" class="required form-control" required="required" /></div><div class="js-form-item form-item js-form-type-textfield form-item-acknowledgement-mailing-addess-address-2 js-form-item-acknowledgement-mailing-addess-address-2 form-group"><label for="edit-acknowledgement-mailing-addess-address-2">Address 2</label><input data-drupal-selector="edit-acknowledgement-mailing-addess-address-2" type="text" id="edit-acknowledgement-mailing-addess-address-2" name="acknowledgement_mailing_addess[address_2]" value="" size="60" maxlength="255" class="form-control" /></div><div class="js-form-item form-item js-form-type-textfield form-item-acknowledgement-mailing-addess-city js-form-item-acknowledgement-mailing-addess-city form-group"><label for="edit-acknowledgement-mailing-addess-city" class="js-form-required form-required">City</label><input data-webform-required-error="Please provide the "City" for the specified street address." data-drupal-selector="edit-acknowledgement-mailing-addess-city" type="text" id="edit-acknowledgement-mailing-addess-city" name="acknowledgement_mailing_addess[city]" value="" size="60" maxlength="255" class="required form-control" required="required" /></div><div class="js-form-item form-item js-form-type-select form-item-acknowledgement-mailing-addess-state-province js-form-item-acknowledgement-mailing-addess-state-province form-group"><label for="edit-acknowledgement-mailing-addess-state-province" class="js-form-required form-required">State</label><select data-webform-required-error="Please select the "State" for the specified street address." data-drupal-selector="edit-acknowledgement-mailing-addess-state-province" id="edit-acknowledgement-mailing-addess-state-province" name="acknowledgement_mailing_addess[state_province]" class="form-select required custom-select" required="required"><option value="" selected="selected">- Select -</option><option value="Alabama">Alabama</option><option value="Alaska">Alaska</option><option value="American Samoa">American Samoa</option><option value="Arizona">Arizona</option><option value="Arkansas">Arkansas</option><option value="Armed Forces (Canada, Europe, Africa, or Middle East)">Armed Forces (Canada, Europe, Africa, or Middle East)</option><option value="Armed Forces Americas">Armed Forces Americas</option><option value="Armed Forces Pacific">Armed Forces Pacific</option><option value="California">California</option><option value="Colorado">Colorado</option><option value="Connecticut">Connecticut</option><option value="Delaware">Delaware</option><option value="District of Columbia">District of Columbia</option><option value="Federated States of Micronesia">Federated States of Micronesia</option><option value="Florida">Florida</option><option value="Georgia">Georgia</option><option value="Guam">Guam</option><option value="Hawaii">Hawaii</option><option value="Idaho">Idaho</option><option value="Illinois">Illinois</option><option value="Indiana">Indiana</option><option value="Iowa">Iowa</option><option value="Kansas">Kansas</option><option value="Kentucky">Kentucky</option><option value="Louisiana">Louisiana</option><option value="Maine">Maine</option><option value="Marshall Islands">Marshall Islands</option><option value="Maryland">Maryland</option><option value="Massachusetts">Massachusetts</option><option value="Michigan">Michigan</option><option value="Minnesota">Minnesota</option><option value="Mississippi">Mississippi</option><option value="Missouri">Missouri</option><option value="Montana">Montana</option><option value="Nebraska">Nebraska</option><option value="Nevada">Nevada</option><option value="New Hampshire">New Hampshire</option><option value="New Jersey">New Jersey</option><option value="New Mexico">New Mexico</option><option value="New York">New York</option><option value="North Carolina">North Carolina</option><option value="North Dakota">North Dakota</option><option value="Northern Mariana Islands">Northern Mariana Islands</option><option value="Ohio">Ohio</option><option value="Oklahoma">Oklahoma</option><option value="Oregon">Oregon</option><option value="Palau">Palau</option><option value="Pennsylvania">Pennsylvania</option><option value="Puerto Rico">Puerto Rico</option><option value="Rhode Island">Rhode Island</option><option value="South Carolina">South Carolina</option><option value="South Dakota">South Dakota</option><option value="Tennessee">Tennessee</option><option value="Texas">Texas</option><option value="Utah">Utah</option><option value="Vermont">Vermont</option><option value="Virgin Islands">Virgin Islands</option><option value="Virginia">Virginia</option><option value="Washington">Washington</option><option value="West Virginia">West Virginia</option><option value="Wisconsin">Wisconsin</option><option value="Wyoming">Wyoming</option></select></div><div class="js-form-item form-item js-form-type-textfield form-item-acknowledgement-mailing-addess-postal-code js-form-item-acknowledgement-mailing-addess-postal-code form-group"><label for="edit-acknowledgement-mailing-addess-postal-code" class="js-form-required form-required">ZIP</label><input data-webform-required-error="Please provide the "ZIP" for the specified street address." data-drupal-selector="edit-acknowledgement-mailing-addess-postal-code" type="text" id="edit-acknowledgement-mailing-addess-postal-code" name="acknowledgement_mailing_addess[postal_code]" value="" size="60" maxlength="255" class="required form-control" required="required" /></div></div><div class="js-form-item form-item js-form-type-textfield form-item-acknowledgement-email js-form-item-acknowledgement-email form-group"><label for="edit-acknowledgement-email">If you would like the final acknowledgement to be sent via email as well, please provide the email address we should sent the document to.</label><input data-drupal-selector="edit-acknowledgement-email" type="text" id="edit-acknowledgement-email" name="acknowledgement_email" value="" size="60" maxlength="255" class="form-control" /></div><div class="js-form-item form-item js-form-type-textarea form-item-comments-23 js-form-item-comments-23 form-group"><label for="edit-comments-23">Please provide other necessary information:</label><textarea data-drupal-selector="edit-comments-23" id="edit-comments-23" name="comments_23" rows="5" cols="60" class="form-textarea form-control"></textarea></div><div id="edit-processed-text" class="js-form-item form-item js-form-type-processed-text form-item- js-form-item- form-no-label form-group"><p><span><span><span><strong>To reiterate, due to the high volume of acknowledgement requests received, please allow a minimum of two weeks (14 days) for processing. </strong></span></span></span></p><p><span><span><span>If you have any questions, please contact our office at (410) 685-9199.</span></span></span></p></div></div></fieldset><fieldset data-drupal-selector="edit-captcha" class="captcha captcha-type-challenge--hcaptcha"><legend class="captcha__title js-form-required form-required"> CAPTCHA: enabled to secure this form. </legend><div class="captcha__element"><input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="2663365" 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