Appendix M to Part 275 - Format for Certificate of Compliance With the Right to Financial Privacy Act of 1978

Appendix M to Part 275 - Format for Certificate of Compliance With the Right to Financial Privacy Act of 1978

Cross Reference

Link to an amendment published at 84 FR 24708, May 29, 2019.

[Official Letterhead]

[Date]

Mr./Mrs. XXXXXXXXX

Manager

Army Federal Credit Union

Fort Anywhere, VA 00000-0000

Dear Mr./Mrs. XXXXXXXXX

I certify, pursuant to section 3403(b) of the Right to Financial Privacy Act of 1978, 12 U.S.C. 3401 et. seq., that the applicable provisions of that statute have been complied with as to the [Customer's authorization, administrative subpoena or summons, search warrant, judicial subpoena, formal written request, emergency access, as applicable] presented on [date], for the following financial records of [customer's name]:

[Describe the specific records]

Pursuant to section 3417(c) of 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.

[Official Signature Block]