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GENERAL This information is provided pursuant to Public Law 93-579, the Privacy Act of December 31, 1974. PURPOSES & USES The information you supply may be used as a basis for an investigation regarding your correspondence with kein , Federal Register Number _763\18- 054 . In the process of conducting the investigation, the Bureau of Prisons may disclose the information to federal, state, or local law enforcement agencies. EFFECTS OF NONDISCLOSURE You are not required to supply the information requested on the attached questionnaire. If you do not furnish the information requested, the processing of your request will be suspended, and you will receive no further consideration. If you furnish only part of the information required, the processing of your request will be attempted; however, it may be significantly delayed. If the information withheld is found to be essential to processing your request properly, you will be so informed, and your request will receive no further consideration unless you supply the missing information. Although no penalties are authorized for failure to supply the requested information, failure to supply the information could result in your not being considered for or allowed admittance to the institution or correspondence privileges with the inmate in question. Page 2 of 10 Revised 2/01/08 DOJ-OGR-00023875