This document is to serve NOTICE to the financial institution, its agents, employees and representatives named herein, that because of the private religious belief of the Citizen named herein, he/she refuses to use a Social Security number. This Right is protected under the Free Exercise of Religion Clause of the national Constitution, the Federal Civil Rights Act, and the provisions of the Federal Privacy Act (Title 5, United States Code, Section 552(a)), which limits the disclosure of a social security number.

In 1974 Congress passed the Federal Privacy Act (Public Law 93-579, 88 Stat. 1896; as amended). The Privacy Act makes it unlawful to require an individual to disclose or furnish a social security number for any purpose, unless the disclosure or furnishing the number was specifically required under federal law.

The relevance of this Act is simply that it highlights the importance of privacy interests associated with social security information. Cf. Wolman v. United States, 501 F.Supp. 310 (D.C.D.C. 1980), remanded 675 F.2d 1341 (D.C. Cir. 1982), vacated on other grounds, 542 F.Supp. 84 (D.C.D.C. 182) (Section 7 of the Privacy Act was intended, the District Court found, to block indiscriminate governmental use of social security information as the "universal identifier."). See United States v. Two Hundred Thousand Dollars in U.S. Currency, 590 F.Supp 866 (S.D. Fla. 1984).

In enacting Section 7, Congress sought to curtail the expanding use of social security numbers by federal and local agencies and, by so doing, to eliminate the threat to individual privacy and confidentiality of information posed by common numerical identifiers. See S.Rep.No. 1183, 93rd Cong., 2nd. Sess., reprinted in [1974] U.S.Code Cong. & Admin. News, pp. 6916, 6944. Underlying this legislative effort was the recognition that widespread use of a standard identification number in collecting information could lead to the establishment of a national data bank or similar informational system, which could store data gathered about individuals from many sources and facilitate government surveillance of its citizens. Id. at 6944-45, 6957. It was anticipated that as the use of the social security number proliferated, the incentive to consolidate records and to broaden access to them by other agencies of government would in all likelihood correspondingly increase. Id. at 6945. Thus, Congress saw a need for federal legislation to restore to the individual the option to refuse to disclose his social security number without repercussion, except in specifically delineated circumstances outlined in section 7(a)(2).

The federal courts have ruled that private sector solicitors may not obtain social security numbers until they comport their solicitations to comply with disclosure requirements of Privacy Act, including informing customers of voluntariness of disclosure, source of authority for it, and possible uses to which disclosed numbers might be put. Yeager v. Hackensack Water Co., 615 F.Supp. 1087 (1985).

Any person who is found in violation of Title 5, United States Code, Section 552(a), for depriving any Citizen of any right, benefit, or privilege provided by law may be subject to "(A) actual damages sustained by the individual as a result of the refusal or failure, but in no case shall a person entitled to recovery receive less than the sum of $1,000.00; and (B) the costs of the action together with reasonable attorney fees as determined by the court." See Doyle v. Wilson, 529 F.Supp. 1343 (1982).

In addition, should it be found that the rights deprived are, in fact, Constitutionally secured, unalienable Rights, any person, who by act or omission, or under color of Law, deprives the bearer of this document of such secured Right, or Rights, protected by the Constitution of the United States of America, may be subject to Fine of up to $10,000.00, and imprisonment for up to ten years, or both. See Title 18, United States Code, Sections 241, 242; as well as: Title 42, United States Code, Sections 1983, 1985 and 1986, providing for additional civil actions for damages.

Since the passage of the Privacy Act, federal regulations which carry the force and effect of law have been promulgated by the Secretary of Treasury prescribing the procedure used in obtaining taxpayer identification numbers. Pursuant to Title 31, Code of Federal Regulations, Section 103.34, banks are required to ask for the social security number when opening a bank account for a new customer, but in the event that the bank has been unable to secure the required information, "it shall nevertheless not be deemed to be in violation of this section if (i) it has made a reasonable effort to secure such identification, and (ii) it maintains a list containing the names, addresses, and account numbers of those persons from whom it has been unable to secure such identification, and makes the names, addresses, and account numbers of those persons available to the Secretary as directed by him."

Reference to the regulations issued by the Board of Governors of the Federal Reserve System outline the requirement for banks to adhere to the regulations promulgated under Title 31 and caution banks not to adopt policies which conflict with and violate federal law and regulations concerning privacy issues.

Compliance with the Law and the Citizen's intent, as expressly evidenced and implied by this document, is demanded.

Non-compliance with this NOTICE AND DEMAND shall result in the filing of a formal complaint with the appropriate state and federal agencies against the below named financial institution and representative(s). immediate action against the below named financial institution and representative(s).

TAKE NOTICE AND GOVERN YOURSELVES ACCORDINGLY.

I, ___________________________________, the undersigned, to hereby verify 

and certify, that on the _____ day of ___________________, 19___, I personally 

handed a copy of this document to ____________________________________________, 

whose title is: ___________________________________.  It is my desire to open 

a checking account with _____________________________________, whose address 

is ___________________________________________________. 

___________________________________

CITIZEN

___________________________________

WITNESS