This letter provides a way for individuals to request that certain privacy act records maintained by them be corrected and cleaned out by the agency who maintains the records.

Our thanks go to Robert Clarkson of Freedom Law School for providing this form.  Let him know you like this form!

You should send your FOIA/Privacy Act  request to the address you locate on the following website:

http://www.irs.gov/prod/preview/foia/offices.html

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PRIVACY ACT REQUEST FOR CORRECTION AND EXPUNGEMENT OF RECORDS

TO:

____________________________ ____________________________ ____________________________ ____________________________

FROM:

____________________________ ____________________________ ____________________________ ____________________________

This is a request under the Privacy Act, 5 U.S.C. Sec, 552a, sub-paragraph (d)(2) for amendment and expungement of records. I hereby request that you expunge from your files the documents or records listed below.I request that you expunge from your files and records each and every document pertaining to how I exercise my rights as guaranteed by the First Amendment of the U.S. Constitution, as provided by Privacy Act (e)(7).

I also request that you expunge from all of your files on me any records which do not fit the criteria as set forth in the Privacy Act (e)(1): “only such information about an individual as is relevant and necessary to accomplish a purpose of an agency required to be accomplished by statute.” Or, which do not meet the statutory requirements of the Privacy Act (e)(5) which requires your agency to “maintain all records which are used by the agency in making any determination about any individual with such accuracy, relevance, timeliness and completeness as is reasonably necessary to assure fairness to the individual.”

For this request, please search each and every file, system of files, or system of records pertaining to me and to this request, in your entire agency.

In particular, I request that you expunge from your records the documents listed below because they do not meet the mandatory requirements of the Privacy Act:

Please send me a copy of your accounting or listing of disclosures of the above-listed documents or any other records pertaining to me including the nature and purpose of each disclosure, the individual and the date to whom they were sent, rev. Privacy Act (c )(1).

    Under the Privacy Act (d)(2), please send me a copy of your guidelines and regulations pertaining to how a citizen might have his records amended and corrected.

Date:_____________________________                    _______________________________________

                                                      Requester