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L: Post-Notice Following Emergency Access—Form DOJ-472

RFPA Form DOJ-472--Post-Notice Following Emergency Access UNITED STATES DEPARTMENT OF JUSTICE Washington, D.C. 20530 POST-NOTICE FOLLOWING EMERGENCY ACCESS Dear ________________________ : (Name of Customer) Records concerning your transactions held by the financial institution named in the attached request were ____________________________ under Section 1114(b) (Government Agency) of the Right To Financial Privacy Act of 1978, 12 U.S.C. Secs. 3401-3422, on ____________ ___ , 19 ___ for the following (Date) purpose: _______________________________________________________ ________________________________________________________________ Emergency access to such records was obtained on the grounds that: __________________________________________________________ ________________________________________________________________ ____________ ____ , 19 ___ ______________________________ (Date) (Name and Title of Official) ___________________________ (Government Agency) ___________________________ (Telephone) ___________________________ (Address) Attachment Sec. 1109(c) of the Right To Financial FORM DOJ-472 Privacy Act, l2 U.S.C. Sec. 3409(c)