(1) Authorizes the disclosure for such period as may be agreed upon;
(2) Indicates an understanding of his or her right to revoke such authorization at any time before the financial records are disclosed;
(3) Identifies the financial records which are authorized to be disclosed;
(4) Specifies the purposes for which, and the state entity to which, such records may be disclosed; and
(5) Acknowledges that he or she has been advised of his or her rights under this article by the state entity seeking the disclosure of the financial records.
(b) No authorization as provided in subsection (a) of this section shall be required as a condition of doing business with any financial institution.
(c) No financial institution shall release the financial records of a customer pursuant to his or her authorization under this section until the state entity seeking the records also provides certification in writing to the financial institution that it has complied with the applicable provisions of this article. The financial institution and the state entity seeking to obtain the disclosure of the financial records shall retain copies of this written authorization.