AUG-19-2019 10:43¶
US ATTORNEY SDNY¶
| 2126372615 | P.007 |
|---|
U.S. Department of Justice¶
Washington, D.C. 20530¶
Request for Financial Information Under the Right to Financial Privacy Act (RFPA) (Authorization, Purchase Order and Receiving Report)¶
Section A - Authorization and Purchase Order¶
4 Name and Address of Financial Institution:¶
Citibank, N.A./Subpoena Compliance 100 Citibank Dr., Bdg. I, Fl.2, San Antonio, TX 78743¶
Funding Certification & Information:¶
Budget Official Number: 54-111 Application Office Number: 9666¶
5 Delivery Records To:¶
See attached subpoena for delivery instructions¶
6 Return Date:¶
See attached¶
7 Remarks:¶
Do not proceed with complaint if the total cost will exceed $500.00 without prior approval. To obtain approval, call the requester listed in Item 8. If invoicing for these services is expected to exceed 20 days, please notify the United States Attorney’s Office immediately to ensure funds remain available for payment. Please see the attached Important Notice for additional information on invoicing and other requirements for reimbursement.¶
8 Name of Recorder:¶
AUSA¶
9 Date of Request:¶
8/19/2019¶
Section B - Financial Institution Invoice¶
No Payment shall be Made Unless Expenses Are Itemized Below Or Set forth On Your Attached Invoice¶
11A Invoice Number:¶
B-08192019-326826¶
11B Tax ID Number:¶
11C Service(s) Records Provided:¶
A. Searching and processing costs (clerical or technical personnel) B. Searching and processing costs (management/supervisory personnel) C. Searching and processing costs (computer support specialist) D. Reproduction Costs (Photocopying). **Note: Copy charges will be disallowed if the information is stored electronically, unless the US Attorney’s Office requests paper.¶
E. Reproduction Costs (Paper Copies of Microfiche; provide justification)¶
F. Reproduction Costs (Duplicate Microfiche; provide justification)¶
G. Storage Media Cost (e.g., Compact DVD, etc., at Actual Cost)¶
H. Transportation Costs (Direct Costs Only)¶
In Item #12, I certify that the services involved above were not performed relative to any corporate accounts and pertain only to accounts of individuals and partnerships of five or fewer individuals.¶
12 Sign:¶
13 Date Signed 09/03/2019¶
16 Disadvance (Sex Atrocious)¶
33.21¶
18 Right to Financial Privacy Act - Paid Law 95-630¶
(12 U.S.C. 3401-3422) Request Pursuant To: (Check One Only)¶
19 Signature of Approving Official:¶
OBJECT CLASS¶
3004 Customer Authorization 3005 Administrative Subpoena or Surveillance 3006 Search Warranty 3007 Judicial Subpoena 3008 Format Writer Request 3413 Gun Jury Subpoena 3414 Special Procedurals¶
20 Funding Source¶
Accounting Code:¶
21 Other Accounting/Fund Information:¶
Program Code: N/A Project Code: N/A YRUDOC: 54-8113¶
Call Number (if applicable):¶
OBJ Month (YRM0) Tax ID Number:¶
To the best of my knowledge, the financial records received, for which we are being hilled, are those of an individual or partnership of five or fewer individuals.¶
FORM USA-211 FEB. 2014¶
Signature of United States Attorney’s Office Represenative¶
Date¶
TOTAL P.007¶
EFTA00124073¶