West Virginia Code § 31A-2B-5

Written authorization for disclosure
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(a) Notwithstanding §31A-2B-4 of this code, a financial institution may disclose a customer's
protected financial information to a government entity if the customer provides the financial
institution with written authorization for said disclosure. The written authorization described
by this section must contain the following:
(1) A statement that the customer consents to the disclosure of the protected financial
information, along with the definition provided in §31A-2B-3(14) of this code, for a specific
period;
(2) A statement that the customer has the right to refuse to consent to disclosure;
(3) A statement that the customer understands his or her right to revoke said consent at any
time before the protected financial information is disclaosed;
(4) A description of the financial records authorizedl to be disclosed;
(5) The purpose for which disclosure of the protected financial information is authorized;
(6) The recipient or recipients of the disclosure; and
(7) The customer's signature.
(b) The written authorization described in this section may not be required as a condition of
doing business or transaLcting with any financial institution.
(c) The written authorization required by this section must be executed distinctly and
separately from other agreements or instruments entered into between the customer and
financial institution.

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