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CRM 1-499

465. Order—Form Q-4

RFPA

Form Q-4 -- Order

IN THE UNITED STATES DISTRICT COURT

FOR THE _______ DISTRICT OF _______

IN RE: GRAND JURY SUBPOENAS

DUCES TECUM, MISC. NO. _____________

(INSERT DATE OF SUBPOENA)

ORDER

The United States of America, having moved that the (insert name of bank) be prohibited from disclosing to its customers certain information concerning service upon it of a Grand Jury subpoena duces tecum, dated (insert date of subpoena) and good cause having been shown that (1) the investigation being conducted is within the lawful jurisdiction of the _______ Grand Jury, (insert month and year) Term; (2) there is reason to believe that the records being sought are relevant to a legitimate inquiry by the _______ Grand Jury; and (3) there is reason to believe that notification to the customer will result in seriously jeopardizing the _______ Grand Jury's investigation, it is hereby

ORDERED that the (insert name of bank) shall not provide its customer, either directly or indirectly, with notice of the fact of service upon it of the Grand Jury subpoena duces tecum, dated (insert date of subpoena), or of the nature of the documents whose production is commanded under the terms of the subpoena, or of the fact that such documents have been produced before the Grand Jury in compliance with the subpoena's terms, for a period of 90 days from the date of service of this Order upon the (insert name of bank); and it is further

ORDERED that this Order and the Government's Motion pursuant to which this Order has been issued shall remain sealed for a period not to exceed 90 days from the date of service of this Order, or until further Order of this court, whichever shall first occur, except that copies of this Order may be served upon the (insert name of bank) and the United States Attorney for the District

of state); and it is further

ORDERED that the copy of the Grand Jury subpoena duces tecum, dated (insert date of subpoena), addressed to the (insert name of bank), attached to the government's Motion seeking issuance of this Order shall remain sealed until the _______ Grand Jury, (insert month and year) Term, concludes the investigation pursuant to which the subpoena has been issued, or until further Order of this Court, whichever shall first occur.

______________________________
UNITED STATES DISTRICT JUDGE

DATED: _________________