A) Indictment (18 U.S.C. Section 1621)

B) Indictment (18 U.S.C. Section 1622)

C) Indictment (18 U.S.C. Section 1623; Two Inconsistent Statements)

D) Indictment (18 U.S.C. Section 1623; One Inconsistent Statement)

INDICTMENT - 18 U.S.C. Sec. 1621

A. On or about the _____ day of _______ , 19 __ , in the _________ District of ____________ , John Doe, having duly taken an oath, before ____________________ a competent officer of the Securities and Exchange Commission during an investigation duly authorized by the Commission, a case in which Title ______ Section ________ authorizes an oath to be administered, that he would testify truly, did willfully and knowingly and contrary to said oath state material matter which he did not believe to be true, that is to say:

B. At the time and place aforesaid the Commission was conducting an investigation into the practices and financial conditions of the XYZ Corporation to determine whether said corporation had violated Title ______ Section ________ .

C. It was material to the aforesaid investigation to determine whether John Doe had ever borrowed money from the XYZ Corporation.

D. At the time and place aforesaid in paragraph 1, John Doe appeared as a witness before the Commission, and then and there being under oath as aforesaid, testified falsely before the Commission with respect to the aforesaid material matter as follows:

"Q. Have you ever borrowed money from XYZ Corporation? A. No."

E. The aforesaid testimony of John Doe, as he then and there well knew and believed, was false in that on January 13, 1974, John Doe did in fact borrow money from the XYZ Corporation. All in violation of 18 U.S.C. Sec. 1621.

INDICTMENT - 18 U.S.C. Sec. 1622

A. On the _____ day of _______ , 19 __ in the __________________ District of ____________________ Richard Roe was adjudicated a bankrupt by the United States District Court for said District and said matter and proceeding was duly referred to James Smith, Referee in bankruptcy of said Court for further proceedings (Referee's No. __________________ ).

B. From on or about the _____ day of ________ , 19 __ , continuing thereafter up to and including the _____ day of _________ , 19 __ , in the _______________ District of ____________________ JOHN DOE, the defendant herein, did wilfully suborn, instigate, induce and procure one Jane Doe to duly take an oath before the said Referee in said bankruptcy proceeding that she would testify truly to material matters relative to the said proceeding concerning the goods, property and debts of the bankrupt and to wilfully and contrary to such oath, state material matter hereinafter more particularly set forth, which neither JOHN DOE nor the said Jane Doe believed to be true.

C. On the _____ day of __________ , 19 __ , the said Jane Doe did appear as required before the said Referee as a witness, was duly sworn and took her oath as a witness in said proceeding, the oath being administered by the said Referee; the said matter and proceeding aforesaid and the hearing thereon before the said Referee as a case in which a law of the United States authorized an oath to be administered.

D. The said Jane Doe, being duly sworn as aforesaid, it did then and there become and at all times mentioned herein was a material matter in the said proceeding whether one ________________ had theretofore and prior to the _____ day of ________ , 19 __, loaned to the said Richard Roe the sum of ____________ .

E. The said Jane Doe, in consequence of said willful subornation, inducement and procurement of JOHN DOE, being under oath as aforesaid, did falsely and knowingly and contrary to said oath, testify in substance and to the following effect that the said ____________ had theretofore and prior to the _____ day of ________ , 19 __ , loaned to the said Richard Roe the sum of _____________ .

F. Said testimony was false and contrary to the oath taken by Jane Doe, as Jane Doe and JOHN DOE then and there well knew and believed, in that ___________________ . All in violation of 18 U.S.C. Sec. 1622.

INDICTMENT - 18 U.S.C. Sec. 1623: Two Inconsistent

Statements

A. On or about the _____ day of _______ , 19 __ , in the ____________ District of ____________ , Richard Roe, while under oath as a witness in a criminal case then being tried before the United States District Court for said District entitled, United States v. John Doe, No. ______ , did knowingly make a material declaration which was inconsistent with a prior material declaration made by RICHARD ROE while testifying in a proceeding before a duly empanelled and sworn grand jury for the United States District Court for the _______________ District of _______________ , such material declarations being inconsistent to the degree that one of them is necessarily false, that is:

B. The said RICHARD ROE on the _____ day of _______ , 19 __ , while under oath as a witness in United States v. John Doe, No. _________ , a criminal trial in the _______________ District of _______________ , did knowingly declare with respect to a material matter as follows:

Q. Have you ever to your knowledge received a loan of money from John Doe?

A. No.

C. The said RICHARD ROE, on the _____ day of _______ , 19 __ , while appearing as a witness under oath before the federal grand jury in the _______________ District of _______________ , did knowingly declare with respect to a material matter as follows:

Q. Have you ever to your knowledge received a loan of money from John Doe?

A. Yes.

D. The irreconcilably contradictory declarations of the said RICHARD ROE quoted in paragraphs 2 and 3 herein were material to the point in question in each of the proceedings before which such declarations were made because it was material to each proceeding to ascertain whether or not John Doe had ever made a loan of money in any amount to RICHARD ROE. All in violation of 18 U.S.C. Sec. 1623.

INDICTMENT - 18 U.S.C. Sec. 1623: One False Statement

A. On the _____ day of ________ , 19 __ , in the ____________ District of ____________________ , RICHARD ROE, while under oath as a witness in a criminal case then being tried before the United States District Court for the said District entitled, United States v. John Doe, Indictment No. ________ knowingly did make a false material declaration, that is to say:

B. At the time and place aforesaid, the Court and Jury were engaged in the trial of the aforementioned case wherein JOHN DOE, the defendant therein, was charged with making an extortionate extension of credit to Richard Roe.

C. It was a matter material to said trial to determine whether or not JOHN DOE had ever made a loan of money in any amount to Richard Roe.

D. At the time and place aforesaid, RICHARD ROE, while under oath, did knowingly declare before said Court and Jury with respect to the aforesaid material matter, as follows:

"Q. Have you ever to your knowledge received a loan of money from John Doe? A. No."

E. The aforesaid testimony of RICHARD ROE, as he then and there well knew and believed, was false in that, on or about _________ , RICHARD ROE did receive a loan of money from John Doe.

All in violation of 18 U.S.C. Sec. 1623.

List of Jury Instructions (18 U.S.C. Secs. 1621, 1622 and 1623)

A) Jury Instructions -- 18 U.S.C. Section 1621

B) Jury Instructions -- 18 U.S.C. Section 1622

C) Jury Instructions -- 18 U.S.C. Section 1623

JURY INSTRUCTIONS -- 18 U.S.C. Sec. 1621

18 U.S.C. Sec. 1621 provides in part that:

Whoever . . . having taken an oath before a competent tribunal, officer, or person, in any case in which a law of the United States authorizes an oath to be administered, that he will testify . . . truly, . . . willfully and contrary to such oath states or subscribes any material matter which he does not believe to be true . . . is guilty of perjury, . .

A. Essential Elements of Offense

Three essential elements are required to be proved in order to establish the offense charged in the indictment:

1. That the testimony was given under oath taken by the accused before the ______________________________ "Agency, Department or Commission" as charged.

2. That the testimony so given was false in one or more of the respects charged; and

3. That the false testimony was willfully given, as charged.

As stated before, the burden is always upon the prosecution to prove beyond a reasonable doubt every essential element of the crime charged; the law never imposes upon a defendant in a criminal case the burden or duty of calling any witnesses or producing any evidence.

B. Willfully

An act is done "willfully" if done voluntarily and intentionally, and with the specific intent to do something the law forbids; that is to say, with bad purpose either to disobey or disregard the law.

C. Proof of Intent

Intent ordinarily may not be proved directly, because there is no way of fathoming or scrutinizing the operations of the human mind. But you may infer the defendant's intent from the surrounding circumstances. You may consider any statement made and done or omitted by the defendant, and all other facts and circumstances in evidence which indicate his/her state of mind. It is ordinarily reasonable to infer that a person intends the natural and probable consequences of acts knowingly done or knowingly omitted.

Section 1306 Federal Jury Practice and Instructions Devitt and Blackmar.

D. Materiality of Testimony

Whether a statement made by a witness before the grand jury of the United States District Court for the __________ District of __________ is material to the investigation then being carried on by the grand jury of the United States District Court for the ____________ District of ____________ is a question of law to be decided by the trial judge, and not by the jury.

If you find beyond a reasonable doubt that the defendant, ________ , did testify to those matters alleged in the indictment, then I instruct you as a matter of law that such testimony was material to the investigation then being conducted by the grand jury.

E. Corroboration of Evidence of Falsity

The law requires in a case such as this that the falsity of the testimony in question be proved by the sworn testimony of at least one witness, and that the testimony as to falsity, given by such witness, be corroborated or supported by other testimony, or by documentary evidence, or by some other evidence in the case.

As to the inapplicability of "two-witness" rule to specified types of cases, see notes to 47.05, Devitt and Blackmar, Federal Jury Practice and Instructions.

JURY INSTRUCTIONS -- 18 U.S.C. Sec. 1622

18 U.S.C. Sec. 1622 provides in part that "whoever procures another to commit perjury" in violation of the laws of the United States "is guilty of subornation of perjury," which is an offense against the United States.

A. Elements of the Offense

Three essential elements are required to be proved in order to establish the offense charged in the indictment, as follows:

1. That the defendant knowingly and wilfully procured ________ to testify before the referee in bankruptcy as to material matters in the bankruptcy proceeding of _______________ , a corporation;

2. That the defendant knew that the testimony which _________ intended to give before the referee was false in one or more of the respects charged in the indictment, and that ____________ knew that it was false in one or more of these respects;

3. That _______________ knowingly and wilfully testified falsely before the said referee in one or more of the respects charged.

As stated before, the burden is always upon the prosecution to prove beyond a reasonable doubt every essential element of the crime charged; the law never imposes upon a defendant in a criminal case the burden or duty of calling any witnesses or producing any evidence.

B. Perjury Must Be Proved

Under the law the actual commission of perjury is a necessary element of the crime of subornation of perjury, and must be established by the same degree of proof required when the alleged perjurer himself is on trial. This means that the falsity of the testimony in question must be proved by the sworn testimony of at least one witness and that the testimony as to falsity must be corroborated or supported by other testimony, or by documentary evidence, or by some other evidence in the case. The proof required for the element of suborning or inducing the perjury, however, is that of proof beyond reasonable doubt just as in the case of other crimes.

(If the perjury suborned was prosecutable under 18 U.S.C. Sec. 1623, the requirement that it be proved by "two-witnesses" is obviated. See United States v. Gross, 375 F. Supp. 971 (D. N.J., 1974)).

JURY INSTRUCTIONS -- 18 U.S.C. Sec. 1623

The statute which it is alleged the defendant has violated reads in pertinent part as follows:

'Whoever under oath . . . in any proceeding before . . . any . . . grand jury of the United States knowingly makes any false material declaration . . . shall be . . .' punished as provided by law.

A. Essential Elements of Offense

Three essential elements are required to be proved in order to establish the offense charged in the indictment:

1. That the testimony was given under oath taken by the accused before the grand jury as charged.

2. That the testimony so given was false in one or more of the respects charged.

3. That the false testimony was knowingly given, as charged.

As stated before, the burden is always upon the prosecution to prove beyond a reasonable doubt every essential element of the crime charged; the law never imposes upon a defendant in a criminal case the burden or duty of calling any witnesses or producing any evidence.

B. Knowingly

An act is done "knowingly" if done voluntarily and intentionally, and not because of mistake or accident or other innocent reason.

C. Materiality of Testimony

Whether a statement made by a witness before the grand jury of the United States District Court for the __________ District of __________ is material to the investigation then being carried on by the grand jury of the United States District Court for the __________ District of __________ is a question of law to be decided by the trial judge, and not by the jury. If you find beyond a reasonable doubt that the defendant, ____________________ , did testify to those matters alleged in the indictment, then I instruct you as a matter of law that such testimony was material to the investigation then being conducted by the grand jury.

D. Specific Intent

The crime charged in this case required proof of specific intent before the defendant can be convicted. Specific intent, as the term implies, means more than the general intent to commit the act. To establish specific intent the government must prove that the defendant knowingly did an act which the law forbids, purposely intending to violate the law.

E. Proof of Intent

Intent ordinarily may not be proved directly, because there is no way of fathoming or scrutinizing the operations of the human mind. But you may infer the defendant's intent from the surrounding circumstances. You may consider any statement made and done or omitted by the defendant, and all other facts and circumstances in evidence which indicate his/her state of mind. It is ordinarily reasonable to infer that a person intends the natural and probable consequences of acts knowingly done or knowingly omitted.

List of Disclosure Forms (26 U.S.C. Sec. 6103 Et Seq.)

A) Sample application to be used when requesting

26 U.S.C. Section 6103(i)(1) information only or joint 26 U.S.C. Section 6103(i)(1) and (i)(2) disclosures.

B) Sample order to be used when requesting either

26 U.S.C. Section 6103(i)(1) information only or joint 26 U.S.C. Section 6103(i)(1) and (i)(2) disclosures.

C) Sample letter to be used when requesting

26 U.S.C. Section 6103(i)(2) information only.

D) Sample application to be used when requesting

returns and return information to locate a fugitive from justice pursuant to 26 U.S.C. Section 6103(i)(5).

E) Sample order to be used when requesting

information pursuant to 26 U.S.C. Section 6103(i)(5).

DISCLOSURE - Sample application to be used when requesting 26 U.S.C. Section 6103(i)(1) information only or joint 26 U.S.C. Section 6103(i)(1) and (i)(2) disclosures.

IN THE UNITED STATES DISTRICT COURT FOR THE _______ DISTRICT OF _______ UNITED STATES OF AMERICA, ) ) v. ) ) ________________________ ) APPLICATION FOR EX PARTE ORDER TO DISCLOSE RETURNS AND RETURN INFORMATION Comes now the United States Attorney for the __________ District of _______ , (Attorney-in-Charge of the ________ Strike Force), pursuant to 26 U.S.C. Section 6103(i)(1), and makes application to the Court for an ex parte order directing the Internal Revenue Service (IRS) to disclose to applicant (and others hereinafter named) returns and return information of Name: Address: Social Security Number or Employer Identification Number: which returns and return information are described as those returns and return information for the taxable period(s): (State year(s) for which disclosure is sought.) In support of its application applicant alleges and states the following: (1) There is reasonable cause to believe based upon information believed to be reliable, that a violation of _____ U.S.C. ______ has been committed. (State facts sufficient to allow the court to so find, and, where necessary, the basis for a belief that the information related is reliable.) (2) There is reasonable cause to believe that the above-described returns and return information are or may be relevant to a matter relating to the commission of such act. (State the connection between the material requested to be disclosed and the ** Page 2 ** matter in issue related to the commission of the crime and facts sufficient for the court to find that such connection exists.) (3) The returns and return information are sought exclusively for use in a federal criminal investigation or proceeding concerning such act. (4) The information sought to be disclosed cannot reasonably be obtained, under the circumstances, from another source. Applicant further alleges and states that in addition to (himself/herself) Name: Title: (It is only necessary to include the names of the attorneys involved in the investigation and/or prosecution.) are personally and directly engaged in investigating the above-mentioned violations of _____ U.S.C. _____ and preparing the matter for trial. The information sought herein is solely for our use for that purpose. No disclosure will be made to any other person except in accordance with the provisions of 26 U.S.C. Section 6103 and 26 C.F.R. Section 301.6103(i)-1. This application is authorized by (name and title of authorizing official). Therefore, applicant prays that this Court enter an order, ex parte, on this application granting disclosure by the Internal Revenue Service of the returns and return information specified in this application. Respectfully submitted, ______________________

DISCLOSURE - Sample order to be used when requesting either 26 U.S.C. Section 6103(i)(1) information only or joint 26 U.S.C. Section 6103(i)(1) and (i)(2) disclosures.

IN THE UNITED STATES DISTRICT COURT FOR THE ______ DISTRICT OF ________ UNITED STATES OF AMERICA ) ) v. ) ) ________________________ ) ORDER FOR DISCLOSURE OF RETURNS AND RETURN INFORMATION On this _____ day of ____________ , 19 , comes for the attention of the Court the application of the United States Attorney for the __________ District of __________, (Attorney-in-Charge of the ____________ Strike Force) for an ex parte order, pursuant to 26 U.S.C. Sec. 6103(i)(1), directing the Internal Revenue Service to disclose returns and return information of: Name: Address: Social Security Number or Employer Identification Number: for the taxable period(s). (State year(s) for which disclosure is sought.) After examining the application the Court finds: (1) There is reasonable cause to believe, based upon information believed to be reliable, that a violation of a federal criminal statute, namely _____ U.S.C. _____, has been committed. (2) There is reasonable cause to believe that the returns and return information are or may be relevant to a matter related to the commission of such act. (3) The returns and return information are sought exclusively for use in a federal criminal investigation or proceeding concerning such act. (4) The information sought to be obtained cannot reasonably be obtained, under the circumstances, from another source. ** Page 2 ** The Court Further finds that applicant and: Name: Title: (It is only necessary to include the names and titles of attorneys involved in the investigation and/or prosecution.) are employees of the United States Department of Justice and are primarily and directly engaged in, and the information sought is solely for their use in, investigating the above-mentioned violation of ______ U.S.C. ______ and preparing the matter for trial; and that the application is authorized by (name of authorizing official). It is therefore ordered that the Internal Revenue Service: (1) disclose such returns and return information of Name: Address: Social Security Number of Employer Identification Number: for the taxable period(s) (state year(s)), as have been filed and are on file with the Internal Revenue Service; (2) certify where returns and return information described above have not been filed or are not on file with the Internal Revenue Service that no such returns and return information have been filed or are on file; (3) disclose such returns and return information described above as come into the possession of the Internal Revenue Service subsequent to the date of this order, but for not longer than 90 days thereafter; (4) disclose such returns and return information and make such certification only to applicant and: Name: Title: ** Page 3 ** (State names of many attornegs involved in the investigation and prosecution.) and to no other person; and (5) disclose no returns or return information not described above. It is further ordered that applicant: Name: Title: and any officer or employee of any federal agency who may be subsequently assigned in this matter shall use the returns and return information disclosed solely in investigating the above-mentioned violation of _____ U.S.C. ______ , and such other violations of any federal criminal statutes, although presently unknown, as are discovered in the course of this this investigation of ______ U.S.C. ______ , and preparing the matter for trial, and that no disclosure be made to any other person except in accordance with the provisions of 26 U.S.C. Sec. 6103 and 26 C.F.R. Sec. 301.6103(i)-1. _______________________________ Judge

DISCLOSURE - Sample letter to be used when requesting 26 U.S.C. Section 6103(i)(2) information only.

Mr./Ms. ________________

District Director

Internal Revenue Service

Street Address

City, State---Zip Code

Attention: Disclosure Officer

Re: Tax Disclosure Pursuant to

26 U.S.C. Sec. 6103(i)(2) (State name of Case) Our Ref: _______________

Dear Mr./Ms. _______________ :

Pursuant to 26 U.S.C. Sec. 6103(i)(2), the Department of Justice requests the Internal Revenue Service to furnish return information, other than taxpayer return information, for the taxable period(s) (state years for which disclosure is sought) regarding (state names, addresses, and Social Security numbers for individual taxpayers; names, addresses, and employer identification numbers for corporations).

The subject(s) of this request is/are the subject(s) of an investigation/indictment regarding possible violations of _____ U.S.C. ______ .

Involved in this investigation/prosecution (state facts).

Disclosure of the requested return information is or may be relevant to the investigation/indictment in establishing (state reasons for relevancy).

Access to the information will be limited to: (state names, title, and addresses of attorneys working on the investigation or prosecution), or such other officers and employees of a federal agancy as shall be specifically assigned to participate in the investigation, preparation for trial, or trial, of this matter. No disclosure will be made to any other person except in accordance with the provisions of 26 U.S.C. Sec. 6103 and 26 C.F.R. Sec. 301.6103(i)-1.

At this time it is anticipated that the disclosed material will be used. State the intended use, i.e., whether the material is sought solely for investigative purposes at the time of the request or whether the requester currently anticipates using the information in a judicial proceeding and an estimated time table.) Therefore, disclosure is required on or before (date).

At this time it is not anticipated that returns and taxpayer return information will be sought pursuant to 26 U.S.C. Sec. 6103(i)(1).

Sincerely, _________________________ Name _________________________ Title

DISCLOSURE - Sample application to be used when requesting returns and return information to locate a fugitive from justice pursuant to 26 U.S.C. Section 6103(i)(5).

IN THE UNITED STATES DISTRICT COURT FOR THE ______ DISTRICT OF _______ UNITED STATES OF AMERICA, ) ) v. ) ) ________________________ ) APPLICATION FOR EX PARTE ORDER TO DISCLOSE RETURNS AND RETURN INFORMATION Comes now the United States Attorney for the _______ District of _________ , (Attorney-in-Charge of the __________ Strike Force), pursuant to 26 U.S.C. Sec. 6103(i)(5), and makes application to the Court for an ex parte order directing the Internal Revenue Service (IRS) to disclose to applicant (and others hereinafter named) returns and return information of: Name: Address: Social Security Number or Employer Identification Number: which returns and return information are described as those returns and return information for the taxable period(s): (State year(s) for which disclosure is sought.) ** Page 2 ** In support of its application applicant alleges and states the following: (1) A federal arrest warrant relating to the commission of a federal felony offense(s) of (list offense(s)) has been issued for the individual(s) named above who (is) (are) (a) fugitive(s) from justice. (2) The return of such individual(s) or return information with respect of such individual(s) is sought exclusively for use in locating (him) (her) (them). (3) There is reasonable cause to believe that such return or return information may be relevant in determining the location of such individual(s). Applicant further alleges and states that in addition to (himself) (herself) Name: Title: (it is only necessary to include the names of the attorneys involved in the investigation and/or prosecution.) are personally and directly engaged in locating the above-mentioned individual(s). No disclosure will be made to any other person except in accordance with the provisions of 26 U.S.C. Sec. 6103. This application is authorized by (Name and Title of authorizing official). Therefore, applicant prays that this Court enter an order, ex parte, on this application, granting disclosure by the Internal Revenue Service of the returns and return information specified in this application. Respectfully submitted, _______________________

DISCLOSURE - Sample order to be used when requesting information pursuant to 26 U.S.C. Section 6103(i)(5).

IN THE UNITED STATES DISTRICT COURT FOR THE ______ DISTRICT OF ________ UNITED STATES OF AMERICA, ) ) v. ) ) ________________________ ) ORDER FOR DISCLOSURE OF RETURNS AND RETURN INFORMATION On this ____ day of ________ , 19 ___ , comes for the attention of the Court the application of the United States Attorney for the ________ District of________ , (Attorney-in- Charge of the ________ Strike Force) for an ex parte order, pursuant to 26 U.S.C. Sec. 6103(i)(5), directing the Internal Revenue Service to disclose returns and return information of: Name: Address: Social Security Number or Employer Identification Number: for the taxable period(s): (State year(s) for which disclosure is sought.) After examining the application the Court finds: (1) A federal arrest warrant relating to the commission of the federal felony offense(s) of (list offense(s)) has been issued for the individual(s) named above who (is) (are) (a) fugitive(s) from justice. (2) The return(s) of such individual(s) or return information with respect to such individual(s) is sought exclusively for use in locating (him) (her) (them). (3) There is reasonable cause to believe that such return or return information may be relevant in determining the location of such individual(s). ** Page 2 ** The Court further finds that applicant and Name: Title: (it is only necessary to include the names and titles of attorneys involved in the investigation and/or prosecution.) are employees of the United States Department of Justice and are primarily and directly engaged in and the information sought is solely for their use in, locating the above named individual(s) who (is) (are) (a) fugitive(s) from justice, and the application is authorized by (name of authorizing official). It is therefore ordered that the Internal Revenue Service (1) Disclose such returns and return information of: Name: Address: Social Security Number or Employer Identification Number: for the taxable period _______________ , 19 ____ , as have been filed and are on file with the Internal Revenue Service; (2) Certify where returns and return information described above have not been filed or are not on file with the Internal Revenue Service that no such returns and return information have been filed or are on file; (3) Disclose such returns and return information described above as come into the possession of the Internal Revenue Service subsequent to the date of this order, but for not longer than 90 days thereafter; (4) Disclose such returns and return information and make such certification only to applicant; and Name: Title: (State names of any attorneys involved in the investigation or prosecution.) (5) Disclose no returns or return information not described above. It is further ordered that applicant and any officer or employee of any Federal agency who say be subsequently assigned to this matter shall use the returns and return information disclosed exclusively for use in locating the above named fugitive(s) and that no disclosure be made to any other person except in accordance with the provisions of 26 U.S.C. Sec. 6103. ______________________________ Judge RIGHT TO FINANCIAL PRIVACY ACT OF 1978 : List of Forms

A) Form DOJ-461 -- Certificate of Compliance with the

Right to Financial Privacy Act of 1978

B) Form DOJ-462 -- Customer Consent and Authorization

for Access to Financial Records

C) Form DOJ-463 -- Formal Written Request for Financial

Records

D) Form DOJ-464 -- Customer Notice

E) Form DOJ-465 -- Motion for Order Pursuant to Customer

Challenge Provisions of the Right to Financial Privacy Act of 1978

F) Form DOJ-466 -- Sworn Statement of Movant

G) Form DOJ-467 -- Application of the United States

Department of Justice for an Ex Parte Order Pursuant to Section 1109 of the Right to Financial Privacy Act of 1978

H) Form DOJ-468 -- Order

I) Form DOJ-469 -- Post-Notice of Search Warrant

J) Form DOJ-470 -- Post-Notice of Search Warrant After

Court-Ordered Delay

K) Form DOJ-471 -- Post-Notice Following Court-Ordered

Delay

L) Form DOJ-472 -- Post-Notice Following Emergency Access

M) Form DOJ-473 -- Notice That No Legal Proceedings Are

Contemplated

N) Form DOJ-474 -- Certification for Transferring Records

Obtained Pursuant to the Right to Financial Privacy Act of 1978

O) Form DOJ-475 -- Formal Written Request for Account

Information and Certificate of Compliance With the Right to Financial Privacy Act

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

Q) Form Q-1 -- Motion for Order Prohibiting Notification of Service

of Grand Jury Subpoenas Duces Tecum

R) Form Q-2 -- Memorandum in Support of Motion for an Order

Prohibiting Notification of the Service of Grand Jury Subpoena

S) Form Q-3 -- Affidavit

T) Form Q-4 -- Order

U) Form R -- Notice

V) Form OBD-211 -- Request for Financial Information

(Authorization, Purchase Order, Receiving Report)

W) Order DOJ 2110.40 -- Right for Financial Privacy Act

Reimbursement Procedures and Reporting Requirements

X) Order DOJ 2110.40 -- Appendix 1

RFPA

Form DOJ-461 -- Certificate of Compliance with the Right to Financial Privacy Act of 1978

UNITED STATES DEPARTMENT OF JUSTICE Washington, D.C. 20530 CERTIFICATE OF COMPLIANCE WITH THE RIGHT TO FINANCIAL PRIVACY ACT OF 1978 TO: _________________________________________________ _________________________________________________ (Name and Address of Financial Institution) FROM: _________________________________________________ (Name of Government Agency) I hereby certify that the applicable provisions of the Right To Financial Privacy Act of 1978, 12 U.S.C. Secs.3401-3422, have been complied with as to the _______________________________________________________________ (Summons, Subpoena or Formal Written Request) presented on ____________ _____ , 19 ___ for the following (Date) financial records of __________________________________________ : _______________________________________________________________ _______________________________________________________________ ____________ _____ , 19 ___ _____________________________ (Date) (Signature) ___________________________ _____________________________ ___________________________ _____________________________ (Address) (Name and Title of Official) ___________________________ _____________________________ (Telephone) (Government Agency) Pursuant to the Right To Financial Privacy Act of 1978, good faith reliance upon this certificate relieves your institution and its employees and agents of any possible liability to the customer in connection with the disclosure of these financial records. Sec. 1103(b) of the Right To Financial FORM DOJ-461 Privacy Act, 12 U.S.C. Sec. 3403(b) 3-10-79

RFPA

Form DOJ-462 -- Customer Consent and Authorization for Access to Financial Records

UNITED STATES DEPARTMENT OF JUSTICE Washington, D.C. 20530 CUSTOMER C0NSENT AND AUTH0RI2ATI0N FOR ACCESS TO FINANCIAL RECORDS I, __________________________________________ , having read the (Name of Customer) explanation of my rights which is attached to this form, hereby authorize the ____________________________________________ (Name and Address of Financial Institution) to disclose these financial records: to ___________________________ , _______________________________ , (Names of Government Authorities Allowed Access) ___________________________ , for the following purpose(s): _________________________________________________________________ _________________________________________________________________ I understand that this authorization may be revoked by me in writing at any time before my records, as described above, are disclosed, and that this authorization is valid for no more than three months from the date of my signature. _______________ ___ , 19 ___ _______________________________ (Date) (Signature of Customer) _______________________________ _______________________________ (Address of Customer) Sec. 1104(a) of the Right To Financial FORM DOJ-462 Privacy Act, 12 U.S.C. Sec. 3404(a) 4-4-79

RFPA

ATTACHMENT to Form DOJ-462 -- Customer Consent and Authorization for Access to Financial Records

UNITED STATES DEPARTMENT OF JUSTICE Washington, D.C. 20530 STATEMENT OF CUSTOMER RIGHTS UNDER THE RIGHT TO FINANCIAL PRIVACY ACT OF 1978 Federal law protects the privacy of your financial records. Before banks, savings and loan associations, credit unions, credit card issuers or other financial institutions may give financial information about you to a Federal agency, certain procedures must be followed. Consent to Financial Records You may be asked to consent to make your financial records available to the Government. You may withhold your consent, and your consent is not required as a condition of doing business with any financial institution. If you give your consent, it can be revoked in writing at any time before your records are disclosed. Furthermore, any consent you give is effective for only three months, and your financial institution must keep a record of the instances in which it discloses your financial information. Without Your Consent Without your consent, a Federal agency that wants to see your financial records may do so ordinarily only by means of a lawful subpoena, summons, formal written request, or search warrant for that purpose. Generally, the federal agency must give you advance notice of its request for your records explaining why the information is being sought and telling you how to object in court. The Federal agency must also send you copies of court documents to be prepared by you #1th instructions for filling them out. Hhile these procedures will be kept as simple as possible, you may want to consult wi,th an attorney before making a challenge to a Federal agency 5 request. Exceptions In some circumstances, a Federal agency may obtain financial information about you without advance notice or your consent. In most of these cases, the Federal agency ** Page 2 ** will be required to go to court to get permission to obtain your records without giving you notice beforehand. In these instances, the court will make the Government show that its investigation and request for your records are proper. When the reason for the delay of notice no longer exists, you will usually be notified that your records were obtained. Transfer of Information Generally, a Federal agency which obtains your financial records is prohibited from transferring them to another Federal agency unless it certifies in writing that the transfer is proper and sends a notice to you that your records have been sent to another agency. Penalties If a Federal agency or financial institution violates the Right To Financial Privacy Act, you may sue for damages or to seek compliance with the law. If you win, you may be repaid your attorney's fees and costs. Additional Information If you have any questions about your rights under this law, or about how to consent to release your financial records, please call the official whose name and telephone number appear below: ___________________________ ______________________________ (Name) ___________________________ (Address) ______________________________ (Title) ___________________________ (Telephone) ______________________________ (Government Agency)

RFPA

Form DOJ-463 -- Formal Written Request for Financial Records

UNITED STATES DEPARTMENT OF JUSTICE Washington, D.C. 20530 FORMAL WRITTEN REQUEST FOR FINANCIAL RECORDS TO: _________________________________________________ _________________________________________________ (Name and Address of Financial Institution) FROM: _________________________________________________ (Name of Government Agency) In connection with a legitimate law enforcement inquiry, you are requested, pursuant to the Right to Financial Privacy Act of 1978, 12 U.S.C. Secs. 34O1-3422, and 28 C.F.R., Part 47, to assemble and __________________________ the following financial (reproduce/make available) records pertaining to _________________________________________ : (Name of Customer or Customers) _______________________________________________________________ _______________________________________________________________ Upon your receipt of a Certificate of Compliance with the Right To Financial Privacy Act of 1978, you will be relieved of any possible liability to the customer in connection with the disclosure of these financial records. ____________ _____ , 19 ___ ______________________________ (Date) ______________________________ ___________________________ (Name and Title of Official) ___________________________ ______________________________ (Address) (Government Agency) ___________________________ (Phone) Remarks: Sec. 1108 of the Right To Financial FORM DOJ-463 Privacy Act, 12 U.S.C. Sec. 3408 ; 4-4-79 28 C.F.R., Part 47

RFPA

Form DOJ-464 -- Customer Notice

UNITED STATES DEPARTMENT OF JUSTICE Washington, D.C. 20530 CUSTOMER NOTICE Dear ________________________ : (Customer) 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: (1) 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. (2) 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): ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ The Right To Financial Privacy FORM DOJ-464 Act, 12 U.S.C. Secs. 3401-3422 4-4-79 ** Page 2 ** (It would simplify the proceeding if you would include with your motion and sworn statement a copy of the attached summons, subpoena or formal written request, as well as a copy of this notice.) (3) 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 ___________________________ ______________________________________________ . (4) Be prepared to come to court and present your position in further detail. (5) 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, ____________ _____ , 19 ___ ______________________________ (Date) ______________________________ ___________________________ (Name and Title of Official) ___________________________ ______________________________ (Address) (Government Agency) ___________________________ (Telephone) 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

RFPA

Form DOJ-465 -- Motion for Order Pursuant to Customer Challenge Provisions of the Right to Financial Privacy Act of 1978

IN THE UNITED STATES DISTRICT COURT FOR THE _______________ DISTRICT OF ________________ (Name of District) (State in which Court is located) ________________________ ) (Your Name) ) Movant ) MOTION FOR ORDER ) PURSUANT TO CUSTOMER v. ) CHALLENGE PROVISIONS ) OF THE RIGHT TO FINANCIAL UNITED STATES DEPARTMENT OF JUSTICE ) PRIVACY ACT OF 1978. Respondent. ) ______________________________ hereby moves this (Your Name) Court, pursuant to Section 1110 of the Right To Financial Privacy Act of 1978, 12 U.S.C. Sec. 3410, for an order preventing the government from obtaining access to my financial records. The agency seeking access is _______________________________ . (Name of Government Agency) My financial records are held by _______________________________ . (Name of Financial Institution) In support of this motion, the Court is respectfully referred to my sworn statement filed with this motion. Respectfully submitted, _____________________________ _________________________ (Your signature) _____________________________ (Your Address) _________________________ (Your Name) _____________________________ (Your Telephone #) CERTIFICATE OF SERVICE I have mailed or delivered a copy of this motion and the attached sworn statement to ____________________________________ (Name of Official listed at item 3 of Customer Notice) on __________ ____ , l9 ___ . (Date) ________________________________ (Your Signature) Sec. 1110 of the Right to Financial Privacy FORM DOJ-465 Act of 1978, 12 U.S.C. Sec. 13410 6-4-79

RFPA

Form DOJ-466 -- Sworn Statement of Movant

IN THE UNITED STATES DISTRICT COURT FOR THE _______________ DISTRICT OF ________________ (Name of District) (State in which Court is located) ________________________ ) (Customer's Name) ) Movant ) Miscellaneous No. _____ ) (Will be filled in by v. ) Court Clerk) ) UNITED STATES DEPARTMENT OF JUSTICE ) SWORN STATEMENT OF MOVANT Respondent. ) I, ________________________ , (am presently/was previously) (Customer's Name) (Indicate One) a customer of __________________________________________________ (Name of Financial Institution) and I am the customer whose records are being requested by the Government. The financial records sought by __________________________ (Name of Government Agency) are not relevant to the legitimate law enforcement inquiry stated in the Customer Notice that was sent to me because ________________________________________________________________ ___________________________________________________________ , or should not be disclosed because there has not been substantial compliance with the Right to Financial Privacy Act of 1978 in that ________________________________________________________ ________________________________________________________________ ______________________________________________________________ , or should not be disclosed on the following other legal basis __________________________________________________________ ______________________________________________________________ . I declare under penalty of perjury that the foregoing is true and correct. ____________ _____ , 19 ___ ______________________________ (Date) (Customer's Signature) Sec. 1110 of the Right to Financial FORM DOJ-466 Privacy Act, 12 U.S.C. Sec. 13410 3-10-79

RFPA

Form DOJ-467 -- Application of the United States Department of Justice for an Ex Parte Order Pursuant to Section 1109 of the Right to Financial Privacy Act of 1978

IN THE UNITED STATES DISTRICT COURT FOR THE _______________ DISTRICT OF ________________ _______________ DIVISION In Re __________________ ) ) Misc. No. _____________________ ) ) APPLICATION OF THE UNITED ) STATES DEPARTMENT OF JUSTICE ) FOR AN EX PARTE ORDER PURSUANT ) TO SECTION 1109 OF THE RIGHT ) TO FINANCIAL PRIVACY ACT OF 1978 The United States Department of Justice hereby applies to this Court, pursuant to Section 1109 of the Right to Financial Privacy Act of 1978, 12 U.S.C. Sec. 3409, for an order delaying for _____ days the customer notification required by Section ________ of the Act in connection with the ____________________________ that ______________________________ (Form of Process or Request) (Departmental Unit) has issued to obtain financial records pertaining to ____________________________ from ______________________________ (Customer) (Name or Financial Institution) and prohibiting ______________________________ , its officers, (Name of Financial Institution) employees, or agents, from disclosing that such records have been released or that a request for such records has been made, on the grounds that, as shown by the attached affidavit: 1. The investigation being conducted is within the lawful jurisdiction of the Government authority seeking the financial records; 2. There is reason to believe that the records being sought are relevant to a legitimate law enforcement inquiry; and, 3. There is reason to believe that the notice will result in: _____________________________________________ (See 12 U.S.C. Sec. 34O9(a)(3)) Respectfully submitted, __________________________ Attachment Sec. 1109 of tha Right to Financial FORM DOJ-467 Privacy Act, 12 U.S.C. Sec. 3409 3-10-79

RFPA

Form DOJ-468 -- Order

IN THE UNITED STATES DISTRICT COURT FOR THE _______________ DISTRICT OF ________________ ) In Re __________________ ) Miscellaneous No. ______________ ) ORDER Upon consideration of the application of the United States for an Order pursuant to Section 1109 of the Right To Financial Privacy Act of 1978, 12 U.S.C. Sec. 3409, and finding that: (1) the investigation being conducted is within the lawful jurisdiction of the government authority seeking access; (2) there is reason to believe that the records being sought are relevant to a legitimate law enforcement inquiry; and (3) there is reason to believe that customer notice will result in: (state specific grounds relied upon under 12 U.S.C. Sec. 34O9(a)(3)) ________________________________________________________________ ________________________________________________________________ it is ORDERED, that notification of ____________________________ (Name of Customer) that his/her records have been sought or obtained may be delayed for no more than ________ days, and it is further ORDERED, that ___________________________________________ , (Name of Financial Institution) its officers, employees, and agents are prohibited, for a period of _____ days from the date of this Order from disclosing that records pertaining to __________________________ (Name of Customer) have been released or that a request for such records has been made. DATED, this _____ day of _____ , l9 __ _______________________________ UNITED STATES DISTRICT JUDGE OR UNITED STATES MAGISTRATE Sec. 1109 of the Right to Financial FORM DOJ-468 Privacy Act of l978, 12 U.S.C. Sec. 3409 3-10-79

RFPA

Form DOJ-469 -- Post-Notice of Search Warrant

UNITED STATES DEPARTMENT OF JUSTICE Washington, D.C. 20530 POST-NOTICE OF SEARCH WARRANT Dear ________________________ : (Name of Customer) Records or information concerning your transactions held by the financial institution named in the attached search warrant were obtained by the ______________________ (Government Agency) on _________________ ____ , 19 ___ for the following purpose: (Date) ________________________________________________________________ ________________________________________________________________ You may have rights under the Right To Financial Privacy Act of 1978, 12 U.S.C. Secs. 340l-3422. _______________ ____ 19 ___ ______________________________ (Date) ______________________________ (Name and Title of Official) ___________________________ ______________________________ (Telephone) ______________________________ (Address) Attachment Sec. 1106 of the Right To Financial FORM DOJ-469 Privacy Act, 12 U.S.C. Sec. 3406 3-10-79

RFPA

Form DOJ-470 -- Post-Notice of Search Warrant After Court-Ordered Delay

UNITED STATES DEPARTMENT OF JUSTICE Washington, D.C. 20530 POST-NOTICE OF SEARCH WARRANT AFTER COURT-ORDERED DELAY Dear ________________________ : (Name of Customer) Records or information concerning your transactions held by the financial institution named in the attached search warrant were obtained by the ______________________ (Government Agency) on _________________ ____ , 19 ___ . (Date) Notification to you was delayed beyond the statutory ninety-day delay period pursuant to a determination by the court that such notice would seriously jeopardize an investigation concerning: ________________________________ . You may have rights under the Right To Financial Privacy Act of 1978, 12 U.S.C. Secs. 3401-3422. ____________ ____ , 19 ___ ______________________________ (Date) ______________________________ ___________________________ (Name of Official and Title) (Telephone) ______________________________ (Government Agency) ______________________________ ______________________________ (Address) Attachment Sec. 3106 of the Right To Financial FORM DOJ-470 Privacy Act, 32 U.S.C. Sec. 3406 3-10-79

RFPA

Form DOJ-471 -- Post-Notice Following Court-Ordered Delay

UNITED STATES DEPARTMENT OF JUSTICE Washington, D.C. 20530 POST-NOTICE FOLLOWING COURT-ORDERED DELAY Dear ________________________ : (Name of Customer) Records or information concerning your transactions which are held by the financial institution named in the attached process or request were supplied to or requested by the Government authority named in the process or request on _______________ ____ , 19 ___ . (Date) Notification was withheld pursuant to a determination by the United States District Court for the _______________ District of __________________ under the Right To Financial Privacy Act of 1978, 12 U.S.C. Secs. 3401-3422, that such notice might: _____________________________________________ ___________________________________________________________ The purpose of the investigation or official proceeding was: _________________________________________________________ . ____________ ____ , 19 ___ ______________________________ (Date) ______________________________ ___________________________ (Name and Title of Official) (Telephone) ______________________________ (Government Agency) ______________________________ ______________________________ (Address) Attachment Sec. 1109(b)(3) of the Right To Financial FORM DOJ-47l Privacy Act, 12 U.S.C. Sec. 3409(b)(3) 3-10-79

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 obtained by the ______________________________________ 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) 3-10-79

RFPA

Form DOJ-473 -- Notice That No Legal Proceedings Are Contemplated

UNITED STATES DEPARTMENT OF JUSTICE Washington, D.C. 20530 NOTICE THAT NO LEGAL PROCEEDINGS ARE CONTEMPLATED Dear ________________________ : (Name of Customer) This letter will notify you that no legal proceedings are now contemplated against you in connection with the investigation for which certain of your financial records were sought from ________________________________________ (Name of Financial Institution) on ____________ ____ , 19 ___ . (Date) This notice to you is required by Section 1110(d)(2) of the Right To Financial Privacy Act of 1978, which is published in 12 U.S.C. Section 3410(d)(2). You have thirty days from the date you receive this letter during which to file an appeal of the United States District Court's decision denying the motion you made. If you wish to appeal, you should file your appeal with the Clerk of the United States Court of Appeals for the ________ Circuit. ______________ ___ 19 ___ ______________________________ (Date) (Name and Title of Official) _________________________ ______________________________ (Telephone) (Government Agency) NOTE: Sec. 1110(d)(2) of the Roght To Financial FORM DOJ-473 Privacy Act, 12 U.S.C. Sec. 3410(d)(2) 3-10-79

RFPA

Form DOJ-474 -- Certification for Transferring Records Obtained Pursuant to the Right to Financial Privacy Act of 1978

UNITED STATES DEPARTMENT OF JUSTICE Washington, D.C. 20530 CERTIFICATION FOR TRANSFERRING RECORDS OBTAINED PURSUANT TO THE RIGHT TO FINANCIAL PRIVACY ACT OF 1978 TO: ____________________________________________________________ (Name and Address of Receiving Agency) FROM: ____________________________________________________________ (Name and Adress of Transferring Government Agency) The records of the following customer of a financial institution are in our possession: _____________________________________________________________ (Name of Customer) _____________________________________________________________ (Address of Customer) _____________________________________________________________ (Type of Records and Account Number) _____________________________________________________________ (Name of Financial Institution) Pursuant to Section 1112(a) of the Right To Financial Privacy Act of 1978, 12 U.S.C. Sec. 3412(a), the records described above are being transferred to you. I certify that there is reason to believe that the records being transferred are relevant to a legitimate law enforcement inquiry within the jurisdiction of your agency or department. ______________ ___ 19 ___ ______________________________ (Date) (Name of Official and Title) _________________________ ______________________________ (Telephone) (Government Agency) Copies to the Following Files: Sec. 1112(a) of the Right to Financial FORM DOJ-474 Privacy Act, l2 U.S.C. Sec. 3412(a) 4-4-79

RFPA

Form DOJ-475 -- Formal Written Request for Account Information and Certificate of Compliance With the Right to Financial Privacy Act

UNITED STATES DEPARTMENT OF JUSTICE Washington, D.C. 20530 FORMAL WRITTEN REQUEST FOR ACCOUNT INFORMATION AND CERTIFICATE OF COMPLIANCE WITH THE RIGHT TO FINANCIAL PRIVACY ACT TO: ____________________________________________ (Name and Address of Financial Institution) FROM: _____________________________________________ (Name and Adress of Government Agency) In connection with a legitimate law enforcement inquiry and pursuant to Section 1113(g) of the Right To Financial Privacy Act of 1978, 12 U.S.C. Section 3413(g), you are requested to provide the following account information: I hereby certify, pursuant to Section 1103(b), the Right To Financial Privacy Act of 1978, 12 U.S.C. Section 3403(b), that the provisions of the Act have been complied with as to this request for account information and that good faith reliance upon this certificate relieves your institution and its employees and agents of any possible liability to the customer in connection with the disclosure of this account information. ______________________________ (Name and Title of Official) ______________________________ (Signature) _____________ ____ l9 ___ (Date) __________________________ ______________________________ (Telephone) (Government Agency) Remarks: Sec. 1113(g) of the Riqht To Financial FORM DOJ-475 Privacy Act, l2 U.S.C. Sec. 3413(g) 3-10-79

RFPA

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

UNITED STATES DEPARTMENT OF JUSTICE Washington, D.C. 20530 NOTICE OF TRANSFER 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) 3-10-79

RFPA

Form Q-1 -- Motion for Order Prohibiting Notification of Service of Grand Jury Subpoenas Duces Tecum

IN TME UNITED STATES DISTRICT COURT FOR THE _______ DISTRICT OF _______ IN RE: GRAND JURY SUBPOENAS ) ) DUCES TECUM, DATED ) MISC. NO. _____________ ) (INSERT DATE) ) MOTION FOR ORDER PROHIBITING NOTIFICATION OF SERVICE OF GRAND JURY SUBPOENAS DUCES TECUM

The United States of America, by ___________________ , United States Attorney for the District of ________________ , and (insert name of Assistant U.S. Attorney) Assistant United States Attorney for said District, moves the Court, pursuant to 12 U.S.C. Section 3409, and 28 U.S.C. Section 1651, and pursuant to the Federal Rules of Criminal Procedure, for an Order prohibiting (insert name of bank) from serving upon its customers notification of the service upon that institution of a Grand Jury subpoena duces tecum, and states as follows:

1. On (insert month and year), this Court assigned to the ________ Grand Jury, (insert month and year), Term, an investigation of (insert brief description of nature of investigation). With the assistance of the Office of the United States Attorney for the District of (insert state) the Special Grand Jury is presently conducting an investigation of certain violations of the federal criminal laws involving (insert brief description of nature of investigation). (On (insert date), that investigation was transferred by the Court to the (insert month and year) Term ______ Grand Jury ______ ).

2. On or about (insert date of subpoena), a subpoena duces tecum was issued, on behalf of the Grand Jury, addressed to the Custodian of Records of (insert name of bank), and calling for production by them of certain financial records before the (insert month and year), Term ________ Grand Jury. A copy of that subpoena is attached hereto. There is reason to believe that the records, whose production is sought under the terms of the subpoena, are relevant to the ________ Grand Jury's present investigation of, (insert investigation description). The subpoena was served upon the (insert name of bank) shortly after its issuance.

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(3. When served vith the Grand Jury's subpoena, the custodian of records of the (insert name of bank) notified the Government that, in accordance with the Bank's policy (and/or applicable state law), the Bank would undertake immediately to notify its customers of the fact of service of that subpoena, despite the fact that such notice is not required by the Right to Financial Privacy Act. Such disclosure to the customers of the financial institution subpoenaed will result in serious prejudice to the _____ Grand Jury's ongoing investigation. In particular, notification of those customers of the service of that subpoena will seriously jeopardize the ______ Grand Jury's investigation by impairing its ability to obtain the testimony of other potential witnesses, (and will seriously jeopardize an ongoing undercover investigative effort presently being conducted by the Federal Bureau of Investigation).)

WHEREFORE, the Government respectfully requests this Court issue an order as follows:

(1) Directing that, for a period not to exceed 90 days, (insert name of bank) shall not provide its customers, either directly or indirectly, with notice of the fact of service of the Grand Jury subpoenas duces tecum dated (insert date of subpoena), or notice of the nature of the documents whose production is commanded under the terms of the subpoena, or notice of the fact that such documents have been produced before the Grand Jury in compliance with the subpoena's terms; and

(2) Commanding that this motion and the order issued pursuant hereto shall remain sealed for a period of time not to exceed 90 days, or until further order of this Court, whichever shall first occur, and providing that a copy of the order issued pursuant hereto may be served upon the custodian of records of the (insert name of bank); and

(3) Commanding that a copy of the Grand Jury subpoena duces tecum dated (insert date of subpoena), attached hereto, shall remain sealed until the ______ Grand Jury, (insert month and year) Term, concludes its present investigation of (insert investigation description), or until further order of this Court, whichever shall first occur.

Respectfully submitted, _______________________ United States Attorney By: _______________________ Assistant U.S. Attorney

(Attach a copy of Grand Jury Subpoena Duces Tecum)

RFPA

Form Q-2 -- Memorandum in Support of Motion for an Order Prohibiting Notification of the Service of Grand Jury Subpoena

IN TME UNITED STATES DISTRICT COURT FOR THE _______ DISTRICT OF _______ IN RE: GRAND JURY SUBPOENAS ) ) DUCES TECUM, DATED ) MISC. NO. _____________ ) (INSERT DATE OF SUBPOENA) ) MEMORANDUM IN SUPPORT OF MOTION FOR AN ORDER PROHIBITING NOTIFICATION OF THE SERVICE OF GRAND JURY SUBPOENA

The United States has moved the Court to prohibit (insert name of bank) from disclosing to its customers, for a period of ninety days, that the bank has been served with a Grand Jury subpoena duces tecum. /1/ The motion is filed under the terms of the Right to Financial Privacy Act, 12 U.S.C. Section 3401 et seq., pursuant to the Court's inherent powers, and under the provisions of the All Writs Act, 28 U.S. C. Section 1651.

The Government's application is made for the soundest of reasons. /2/ The Order whose entry is requested is framed in terms that parallel precisely the terms of the delayed-notice provisions of the Right to Financial Privacy Act, 12 U.S.C. Section 3409. And, the Order has been framed to be issued pursuant to the Court's inherent powers, and under the terms of the All Writs Act, 28 U.S.C. Section 1651. See United States v. New York Telephone Co., 434 U.S. 159, 172-178 (1977). The Order is drawn so that

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/1/ The requested Order would also prohibit the financial institution from notifying its customers of the matter of the documents subpoenaed, and of the nature and extent of compliance by the institutions with the subpoena's terms.

/2/ The reasons advanced by the Government are explicated fully in an Affidavit filed ex parte and in camera together with this pleading. The government contends that the financial institution and its customers are not entitled to those reasons at this time, and requests the court to retain the Affidavit filed by the government under seal of court.

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no one will be prohibited from relating "facts within their knowledge acquired beyond the grand jury room;" United States v. Central Supply Association, 34 F. Supp. 241, 245 (N.D. Ohio 1940). Rather, by the least restrictive available means, the Order will simply defer the time at which the (insert name of bank) will become free to disclose publicly what it stated to or learned from the Grand Jury; King v. Jones, 319 F. Supp. 653, 658-659 (N.D. Ohio 1940).

In pertinent part, Rule 6(e) of the Federal Rules of Criminal Procedure provides that "No obligation of secrecy may be imposed upon any person except in accordance with this rule." /3/ Although seemingly absolute on its face, those parts of Rule 6(e) were designed to ameliorate the "unnecessary hardship" of imposing an oath of secrecy upon the witness concerning testimony before the grand jury. See Fed. R. Crim. P., Rule 6(e), Advisory Committee Note 2 (emphasis supplied). /4/

Both prior and subsequent to the enactment of Rule 6(e) of the Federal Rules of Criminal Procedure, the courts have recognized that some circumstances exist in which some appropriate limitation upon disclosure

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/3/ Rule 6(e) of the Federal Rules of Criminal Procedure provides:

(1) General Rule -- A grand jury, an interpreter, a stenographer, an operator of a recording device, a typist who transcribes recorded testimony, an attorney for the Government, or any person to whom disclosure is made under paragraph (2)(A)(ii) of this subdivision shall not disclose matters occurring before the grand jury, except as otherwise provided for in these rules. No obligation of secrecy may be imposed on any person except in accordance with this rule. A knowing violation of Rule 6 may be punished as a contempt of court. (Emphasis added.)

/4/ Whatever "hardship" may be imposed upon the witnesses served with the requested Orders is clearly not "unnecessary." To the contrary, the imposition of any such "hardship" is essential to preserve the legitimate functions of the grand jury and the integrity of the judicial process itself. And, whatever "hardship" may be imposed is, in any event, not overly burdensome on either those subject to the orders or the customers themselves.

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of matters may be imposed upon grand jury witnesses, despite the seemingly absolute language of the Rule. In Goodman v. United States, 108 F.2d 516 (9th Cir. 1939), the court found it "well within the descretionary power of the court to impose an obligation of secrecy not alone upon grand jurors, but upon the witnesses, if the court believes the precaution necessary in the investigation of crime." Id. at 520. And, in United States v. Central Supply Association, 34 F. Supp. 241, 245 (N.D. Ohio 1940), the court enumerated at least five circumstances in which such a precaution might be found "necessary in the investigation of crime." See King v. Jones, supra, 319 F. Supp., at 658.

Following the enactment of Rule 6(e) of the Federal Rules of Criminal Procedure in 1946, 5 F.R.D. 573, 583 (1946), /5/ the witness secrecy provision of Rule 6(e) of the Federal Rules of Criminal Procedure was not subjected to judicial scrutiny until the decision in United States v. Smyth, 104 F. Supp. 279 (N.D. Cal. 1952). Finding that the rule enunciated in Goodman survived the enactment of Rule 6(e) of the Federal Rules of Criminal Procedure, the Smyth court noted that:

. . . the secrecy of grand jury proceedings is of substance and not of procedure. The power of the trial court to enforce secrecy is jurisdictional and a necessity if grand juries are to function. The Federal Constitution encysted the common law grand

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/5/ It is interesting to note that one of the framers of Rule 6(e) of the Federal Rules of Criminal Procedure suggested that the Rule itself contemplated the possible imposition of a limited oath of secrecy upon grand jury witnesses, and that the purpose of including the witness secrecy provision of the Rule was only to circumscribe the type of oath which might properly be imposed. After noting that the "Rule is specific that 'no obligation of secrecy may be imposed on any person except in accordance with this rule,'" George F. Longsdorf, a member of the Advisory Committee that drafted the original version of the Federal Rules of Criminal Procedure, suggested in 1951, that the "rules do not prescribe the forms of oaths to be taken by grand jurors or by witnesses called before the grand jury." That fact was mentioned, he added, "to make allusion to the practices sometimes formerly followed of exacting before Federal grand juries a form of oath to witnesses which exacted greater secrecy than Rule 6(e) requires." G.F. Longsdorf, The Beginnings and Background of Federal Criminal Procedure, in 4 W.W. Barron, Federal Practice and Procedure, at 24 (Rules ed. 1951).

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jury with all its incidents. The Rules could not change the Constitution nor prevent the court from imposing secrecy upon everyone in connection with such a proceeding in the public interest. See also United States v. Central Supply Association, 34 F. Supp. 241 (N.D. Ohio 1940). Symth, supra, 104 F. Supp. at 280-81, n.5.

The same conclusion has been reached by each of the other courts that have considered the courts' powers to impose some appropriate limitations upon the disclosures which federal grand jury witnesses are able to make. See In re Proceedings Before The Grand Jury Summoned October 12, 1970, 321 F. Supp. 238, 240 (N.D. Ohio 1970); King v. Jones, supra 319 F. Supp., at 657; In re Grand Jury Witnesses, 370 F. Supp. 1282, 1285 n.5 (S. D. Fla. 1974).

Furthermore, the entry of an Order such as that requested here is well within the powers of the Court. The grand jury is an arm of the court, which exercises jurisdiction of persons and subjects under the authority and supervision of the Court. In re Long Visitor, 523 F.2d 443, 446-47 (8th Cir. 1975), and In re Gompman, 531 F.2d 262, 266 (5th Cir. 1976). As the Supreme Court noted in Brown v. United States, 359 U.S. 41, 49 (1958):

A grand jury is clothed with great independence in many areas, but it remains an appendage of the court, powerless to perform its investigative function without the court's aid, because powerless itself to compel the testimony of witnesses. It is the court's process which summons the witness to attend and give testimony, and it is the court which must compel a witness to testify if, after appearing, he refused to do so. /6/

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/6/ Since the grand jury is able to compel the attendance of witnesses only through the use of the district court's process, it might well be argued that the district court has the power in this case to issue the requested Orders as a logical derivative of its power to issue the subpoenas duces tecum to which the Order relates, under Rule 17 of the Federal Rules of Criminal Procedure. In such case the witness secrecy provision of Rule 6(e) of the Federal Rules of Criminal Procedure may not be called into play at all.

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See also O'Bryan v. Chandler, 352 F.2d 987, 990 (10th Cir. 1965); In re A & H Transportation, Inc., 319 F.2d 69, 71 (4th Cir. 1963); and In re Seiffert, 446 F. Supp. 1153 (N.D. N.Y. 1978). The power of a district court to enforce secrecy is jurisdictional and an incident of the court's supervisory authority over grand juries "encysted" by the Constitution. See United States v. Smyth, supra, at 280-81, n.5.

Federal courts are endowed by All Writs Act, Title 28, United States Code, Section 1651, with "the power to issue such commands . . . as may be necessary to effectuate and prevent the frustration of orders . . . previously issued in (the) exercise of jurisdiction otherwise obtained." United States v. New York Telephone Co., supra, at 172. While "the power of federal courts to impose duties upon third parties is not without limits," id., the district courts should be "trusted to exercise their powers under the All Writs Act only in cases of clear necessity and to balance the burden imposed upon the party required to render assistance against the necessity." Id. at 165, n.5. Though "unreasonable burdens may not be imposed," the power conferred by the All Writs Act is available "as a 'legislatively approved source of procedural instruments designed to achieve "the rational ends of law" ' " Id. at 172, citing Harris v. Nelson, 394 U.S. 286, 299 (1969); and Price v. Johnston, 334 U.S. 266, 282 (1948).

The requested Order is sought under the terms of the All Writs Act, to render effective the process of this grand jury. That process consists in the subpoena duces tecum to which the Order relates. The subpoena is no more than "orders . . . previously issued in (the) exercise of jurisdiction otherwise obtained" and properly exercised, either directly by the district court or through its investigative arm, the grand jury. The requested Order is simply a "command" issued by the court, in the exercise of its discretion, "necessary to effectuate and prevent the frustration" of the grand jury's process. Appropriately balancing "the burden imposed upon the party required to render assistance against the necessity" presented by the facts which compelled the government to seek issuance of the Order, the government contends that the Court should find the Order both permissible and necessary under these circumstances; essential to preserve the legitimate functions of the grand jury; rationally related to the reasons for which it is sought; and not overly burdensome on those subject to the Order or on the customers of (insert name of the bank). Compare United States v. New York Telephone Co., supra at 174.

Finally, the court should note that the entry of an Order such as that sought here is not without precedent. Indeed, in a recent decision, the Fourth Circuit implicitly approved the entry of such an Order under similar circumstances. See In re Swearingen Aviation Corporation, etc., 4486 F. Supp. 9 (D. Md.), aff'd 605 F.2d 125 (4th Cir. 1979).

Page 6 Respectfully submitted, ________________________ United States Attorney By: ________________________ Assistant U.S. Attorney

RFPA

Form Q-3 -- Affidavit

IN TME UNITED STATES DISTRICT COURT FOR THE _______ DISTRICT OF _______ IN RE: GRAND JURY SUBPOENAS ) ) DUCES TECUM, ) MISC. NO. _____________ ) (INSERT DATE OF SUBPOENA) ) SAMPLE AFFIDAVIT

I HEREBY CERTIFY that on this ____ day of ________ , l981, before me, a Notary Public in and for the City of (insert name of city and state), personally appeared (name of affiant) and made oath in due form of law as follows:

1. The affiant is a Criminal Investigator employed by the (insert name of agency) and assigned the responsibility of assisting the (insert month and year) Term ______ Grand Jury in its investigation of certain offenses against the Federal criminal laws involving (insert brief description of nature of investigation).

2. With the assistance of the affiant, the United States Attorney, and Assistant United States Attorney (insert name of Assistant U.S. Attorney), the Grand Jury is continuing an investigation begun by the (insert name of agency) into allegations that (describe allegations under investigation by the grand jury).

3. Notification of service of the subpoena duces tecum upon the (insert name of bank) will directly alert several persons, including (insert name), to the existence, and perhaps to the nature, of the Grand Jury's investigation. Such notification (will seriously jeopardize the undercover investigative efforts presently conducted by the (insert name of agency) and) will impair the ability of the Grand Jury to obtain testimony and other evidence concerning the violations of federal law now under investigation. Consequently, the government has sought the issuance of an Order, under the terms of the Right to Financial Privacy Act, Title 12, United States Code, Section 3401, et seq., the Court's inherent

Page 2

powers, and the All Writs Act, Title 28, United States Code, Section 1651, to delay for 90 days the notification of any customer of the financial institution of the fact of service of the subpoena; of the nature of the documents subpoenaed; and of the fact that such records have been produced in compliance with the terms of the subpoena.

4. The Government will move the Court to vacate the Order as expeditiously as practicable to limit as much as possible the potential infringement upon the rights of the Bank to speak freely about the subpoena with which it has been served.

_________________________ (INSERT NAME OF AFFIANT) _____________________________ NOTARY PUBLIC MY COMMISSION EXPIRES: _________________________

RFPA

Form Q-4 -- Order

IN TME 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 (insert name 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

Page 2

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: _________________

RFPA

Form R -- Notice

NOTICE

A. Pursuant to the Right to Financial Privacy Act, Title 12, United States Code, Section 3415, financial institutions may be reimbursed for necessary costs actually incurred effective October 1, 1979. The Federal Reserve Board has established the following guidelines:

1. Search and Processing Costs -- May be billed at the rate of $2.50 per quarter hour, or fraction thereof, for time spent by employees locating and retrieving documents, reproducing documents, or packaging and preparing documents for shipment. Computer time and necessary supplies may also be billed if itemized separately.

2. Reproduction Costs -- May be billed at a rate of 15 cents per page:

3. Transportation Costs -- May bill for direct costs incurred to transport employees to locate and and retrieve material required. May also bill for direct costs incurred in transporting material to location required by legal process.

B. An itemized bill or invoice must be furnished the United States Attorney in order to receive reimbursement. However, reimbursement may be made only in connection with the following types of financial records: checking, savings, share, loan or credit card account records pertaining to accounts of individuals or partnerships of five or fewer partners. Reimbursement cannot be made for records relating to accounts of:

1. Corporations

2. Large partnerships (6 or more partners)

3. Associations

4. Trusts

5. Government agencies

6. Other legal entities

You may refer to the Federal Register, Volume 44, No. 190, September 28, 1979, pp. 55812-55815, for more detailed guidelines. If you have further questions, please contact:

________________________________ ____________________________________ ____________________________________

RFPA

Form OBD-211 -- Request for Financial Information (Authorization, Purchase Order, Receiving Report)

%02

REQUEST FOR FINANCIAL INFORMATION (AUTHORIZATION, PURCHASE ORDER, RECEIVING REPORT) SEE FORM OBD-211 (May 81) (This form is not conducive to duplication on JURIS)

RFPA

Order DOJ 2110.40 -- Right for Financial Privacy Act Reimbursement Procedures and Reporting Requirements

DEPARTMENT ORDER OF JUSTICE DOJ 2110.40 Apr. 30, 1980 SUBJECT: RIGHT TO FINANCIAL PRIVACY ACT REIMBURSEMENT PROCEDURES AND REPORTING REQUIREMENTS -----------------------------------------------------------------

1. PURPOSE. This order provides procedures for the payment of

fees to financial institutions and for the preparation of the congressional report as required by the Right to Financial Privacy Act of 1978, P.L. 95-630, 12 U.S.C. 3401 et seq.

2. SCOPE. The provisions of this order apply to all Offices,

Boards, Divisions, and Bureaus of the Department of Justice.

3. CANCELLATION. This order cancels Order DOJ 2740.2.

4. SUMMARY. Section 3415 of Title 12 of the U.S. Code requires

Government authorities under limited circumstances to reimburse financial institutions for the direct costs incurred in researching, assembling, reproducing, and transmitting financial information on individuals and partnerships comprised of five or fewer persons. 12 U.S.C. 3421(b) requires the submission of an annual report to the Congress on requests for financial records and incidents of judicially delayed notification relating thereto. The Assistant Attorney General for Administration (AAG/A) is assigned the responsibility for preparing the Department report. In order to facilitate the preparation of the report, a standardized reporting format (Appendix 1) has been developed for submission to the AAG/A and for the consolidated Department report to the Congress.

5. DEFINITIONS

a. Financial Institution. Any office of a bank, savings

bank, card issuer as defined in Section 103 of the Consumers Credit Protection Act (15 U.S.C. 1602(n)), industrial loan company, trust company, savings and loan, building and loan, or homestead association (including cooperative banks), credit union, or consumer finance institution, located in any State or territory of the United States, the District of Columbia, Puerto Rico, Guam, American Samoa, or the Virgin Islands. ------------------------------------------------------------------- DISTRIBUTION: INITIATED BY: Bureau Financial Managers Justice Management Division OBD/H-2 Finance Staff

** Page 2 **

b. Financial Record. An original of, a copy of, or

information known to have been derived from any record held by a financial institution pertaining to a customer's relationship with the financial institution.

c. Government Authority. Any agency or department of the

United States, or any officer, employee or agent thereof.

d. Person. An individual or a partnership of five or fewer

individuals.

e. Customer. Any person or authorized representative of that

person who utilized or is utilizing any service of a financial institution, or for whom a financial institution is acting or has acted as a fiduciary, in relation to an account maintained in the person's name. "Customer" does not include corporations or partnerships comprised of more than five persons.

f. Directly Incurred Costs. Costs incurred solely and

necessarily as a consequence of searching for, reproducing or transporting books, papers, records, or other data, in order to comply with legal process or a formal written request or a customer's authorization to produce a customer's financial record. The term does not include any allocation of fixed costs (overhead, equipment, depreciation, etc.). If a financial institution has financial records that are stored at an independent storage facility that charges a fee to search for, reproduce, or transport particular records requested, these costs are considered to be directly incurred by the financial institution.

6. COST REIMBURSEMENT PROCEDURES. Each Office, Board, Division and

Bureau which requires or requests access to financial records pertaining to a customer shall pay to the financial institution that assembles or provides the financial records a fee for reimbursement of reasonably necessary costs vhich have been directly incurred. Paragraph 6a sets forth reisbursable costs and rates for reimbursement. Incurred costs for requests for assembling or providing certain types of financial records which are not reimbursable are set forth in paragraph 6b. Action required for payment of reimbursable costs are contained in paragraph 6c.

a. Allowable Costs.

(1) Search and processing costs.

(a) Reimbursement of search and processing costs shall be for the total amount of personnel direct time incurred in locating and retrieving, reproducing, packaging and preparing financial records for shipment. Par. 5 Page 2

** Page 3 **

(b) The rate for search and processing costs is $10 per hour per person, computed on the basis of $2.50 per quarter hour or fraction thereof, and is limited to the total amount of personnel time spent in locating and retrieving documents or information or reproducing or packaging and preparing documents for shipment where required or requested by a government authority. Specific salaries of such persons shall not be included in search costs. In addition, search and processing costs do not include salaries, fees, or similar costs for analysis of material or for managerial or legal advice, expertise, research, or time spent for any of these activities. If itemized separately, search and processing costs may include the actual cost of extracting information stored by computer in the format in which it is normally produced, based on computer time and necessary supplies; however, personnel time for computer search may be paid only at the rate specified in this paragraph. (2) Reproduction costs (a) Reimbursement for reproduction costs shall be for costs incurred in making copies of documents required or requested. (b) The rate for reproduction costs for making copies of required or requested documents is l5 cents for each page, including copies produced by reader/printer reproduction processes. Photographs, films, and other materials are reimbursed at actual cost. (3) Transportation costs. Reimbursement for transportation costs shall be for necessary costs directly incurred to transport personnel to locate and retrieve the information required or requested, and necessary costs directly incurred solely by the need to convey the required or requested material to the place of examination.

b. Exceptions. A financial institution is not entitled to

reimbursement for costs incurred in assembling or providing the following financial records or information.

(1) Security interests, bankruptcy claims, debt collection.

Any financial records provided as an incident to perfecting a security interest, proving a claim in bankruptcy, or otherwise collecting a debt owing either to the financial institution itself or in its role as fiduciary. Par. 6 Page 3

** Page 4 **

(2) Government Loan Programs. Financial records provided in

connection with a government authority's consideration or administration of assistance to a customer in the form of a government loan, loan guaranty, or loan insurance program or as an incident to processing an application for assistance to a customer in the form of a government loan, loan guaranty, or loan insurance agreement; or as an incident to processing a default on, or administering, a government-guaranteed or insured loan, as necessary authority to permit a responsible government authority to carry out its responsibilities under the loan, loan guaranty, or loan insurance agreement.

(3) Nonidentifiable Information. Financial records that are

not identified with or identifiable as being derived from the financial records of a particular customer.

(4) Federally Required Reports. Financial records required

to be reported in accordance with any federal statute or rule promulgated thereunder.

(5) Government Civil or Criminal Litigation. Financial

records sought by a government authority under the Federal Rules of Civil or Criminal Procedure or comparable rules of other courts in connection with litigation to which the government authority and the customer are parties. NB. This exception does not apply to grand Jury subpoenas. A financial institution is entitled to reimbursement for the costs incurred in providing records, data or information pursuant to a subpoena or court order issued in connection with proceedings before a grand jury. 12 U.S.C. 3413(i), 3415.

(6) Administrative Agency Subpoenas. Financial records

sought by a government authority pursuant to an administrative subpoena issued by an administrative law judge in an adjudicatory proceeding subject to Section 554 of Title 5, U.S. Code, and to which the government authority and the customer are parties.

(7) Identity of Accounts in Limited Circumstances. Financial

information sought by a government authority in accordance with the Right to Financial Privacy Act and for a legitimate law enforcement inquiry, and limited only to the name, address, account number and type of account of any customer or ascertainable group of customers associated with a financial transaction or class of financial transactions, or with a foreign country or subdivision thereof in the case of government authority exercising financial controls over foreign accounts in the United States under Section 5(b) of the Trading With The Par. 6 Page 4

** Page 5 **

Enemy Act (50 U.S.C. App. 5(b); the International Emergency Economic Powers Act (Title II, P.L. 95-223); or Section 5 of the United Nations Participation Act (22 U.S.C. 287(c)).

(8) Investigation of a Financial Institution or its

Noncustomers. Financial records sought by a government authority in connection with a lawful proceeding, investigation, examination or inspection directed at the financial institution in possession of such records or at a legal entity or person which is not a customer.

c. Payments. Payments are to be made for reasonably necessary

direct costs incurred by the financial institution. Payments will be for work completed or for work done prior to withdrawal of the request or legal process. No payments will made without an itemized bill or invoice which identifies costs as search and processing, reproduction, and transportation. See 6a(1), (2) and (3) above. See 12 CFR 219.6. The cost of furnishing such records shall be charged to the organizational appropriation of the official who directly obtained the legal process for the production of the financial records.

7. REPORTING PROCEDURES. The head of each Office, Board, Division

and Bureau which accesses financial records pursuant to 12 U.S.C. 3404, 3405, 3406, 3407, 3408, 3414, or 3420 shall submit to the Office of the Controller, Justice Management Division, a report by February 28 covering the preceding calendar year. This report shall enumerate the number of requests for financial records made under each of the above sections. The information regarding requests under l2 U.S.C. 3420 (grand jury requests) is being collected for Departmental use, and will not be included in the congressional submission. The report will also reflect organization experience under the subject Act for the reporting period. The individual reports will be consolidated by the Office of the Controller and directed to the AAG/A for submission to the House Banking, Finance and Urban Affairs Committee and the Senate Banking, Housing, and Urban Affairs Committee by April 30 of each year. Appendix 1 sets forth an acceptable format for reporting the required information.

8. IMPLEMENTING PROCEDURES. The Administrator of the Drug

Enforcement Administration, Commissioner of the Immigration and Naturalization Service, Director of the Federal Bureau of Investigation, and the Deputy Assistant Attorney General for Administration, Office of the Controller, for the Offices, Par. 6 Page 5 ** Page 6 ** Boards, Divisions and U.S. Marshals Service shall promulgate procedural directives in accordance with the guidance contained in this order.

/s/ WILLIAM D. VAN STAVOREN,

Acting

for Kevin D. Rooney

Assistant Attorney General

for Administration

Par. 8 Page 6

RFPA

Order DOJ 2110.40 -- Appendix 1

DOJ 2110.40 Apr. 30, 1980 APPENDIX 1. REPORT FORMAT AND CONTENT Calendar Year Ended December 31, 19 ___ 12 USC Number of Occasions of Section Requests Presented Delayed Notice 12 U.S.C. Sec. 3404: Customer Authorizations XXX XXX 12 U.S.C. Sec. 3405: Admin. Subpoenas and Summonses XXX XXX 12 U.S.C. Sec. 3406: Search Warrants XXX XXX 12 U.S.C. Sec. 3407: Judicial Subpoena XXX XXX 12 U.S.C. Sec. 3408: Formal Written Requests XXX XXX Subtotal: XXX XXX 12 U.S.C. Sec. 3414: Special Procedures XXX XXX Total: XXX XXX --------------------------------------------------------------------- Number of Requests Presented 12 U.S.C. Sec. 3420*: Grand Jury Information XXX N.A. -------------------------------------------------------------------- Assessment of Experience Organizations shall show the amount of payments made to the financial institutions for direct costs incurred for providing requested information (pursuant to 12 U.S.C. Sec. 3415). Also, they shall specify the operational impact of the Act (e.g., time delays encountered; number of times injunctive relief sought, and granted; experience with the courts and financial institutions; workload impact; etc.) *Will not be included in the congressional report. Appendix 1 DOJ-1980-05 Page 1