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461

P: Notice of Transfer of Financial Records—Form DOJ-476

RFPA

Form DOJ-476-- Notice of Transfer of Financial Records

UNITED STATES DEPARTMENT OF JUSTICE

Washington, D.C.

** OF FINANCIAL RECORDS

Dear ________________________ :

(Name of Customer)

Copies of, or information contained in, your financial records lawfully in the possession of __________________________

(Government Agency)

have been furnished to ________________________________ pursuant

(Government Agency)

to the Right to Financial Privacy Act of 1978 for the following purpose: _____________________________________________ _______________________________________________________________ .

If you believe that this transfer has not been made to further a legitimate law enforcement inquiry, you may have legal rights under the Right To Financial Privacy Act of 1978 or the Privacy Act of 1974.

____________ ____ , 19 ___

(Date)

___________________________

(Name and Title of Official)

___________________________

(Telephone)

___________________________

(Government Agency)

___________________________

(Address)

Sec. 1112(b) of the Right To Financial FORM DOJ-476

Privacy Act, 12 U.S.C. Sec. 3412(b)