Form DOJ-464-- Customer Notice
UNITED STATES DEPARTMENT OF JUSTICE
Washington, D.C. 20530
Dear ________________________ :
Records or information concerning your transactions held by the financial institution named in the attached subpoena, summons, or formal written request are being sought by the _________________________________________ (Government Agency) in accordance with the Right To Financial Privacy Act of 1978, 12 U.S.C. Secs. 34O1-3422, for the following purpose(s):
If you desire that such records or information not be made available, you must:
- Fill out the accompanying motion paper and sworn statement (as indicated by the instructions beneath each blank space) or write one of your own, stating that you are the customer whose records are being requested by the Government, and either giving the reasons you believe that the records are not relevant to the legitimate law enforcement inquiry stated in this notice or any other legal basis for objecting to the release of the records.
- File the motion and sworn statement by mailing or delivering them to the Clerk of any one of the following United States District Courts (in some cases, there will be only one appropriate court): (It would simplify the proceeding if you would include withyour motion and sworn statement a copy of the attachedsummons, subpoena or formal written request, as well as a copy of this notice.)
- Serve the Government authority requesting the records by mailing (by registered or certified mail) or by delivering a copy of your motion and sworn statement to ____________________________________________________ .
- Be prepared to come to court and present your position in further detail.
- You do not need to have a lawyer, although you may wish to employ one to represent you and protect your rights.
If you do not follow the above procedures, upon the expiration of ten days from the date of service or fourteen days from the date of mailing of this notice, the records or information requested therein may be made available. These records may be transferred to other Government authorities for legitimate law enforcement inquiries, in which event you will be notified after the transfer.
Very truly yours,
(Name and Title of Official)
(Address) (Government Agency)
___________________________ ____________ _____ , 19 ___
Enclosures: Summons, Subpoena or Formal Written Request
Motion Form Sworn Statement Form
The Right To Financial Privacy Act, 12 U.S.C. Secs. 3401-3422