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(To be used in residential, business, and commercial seizures.)
PROPERTY INFORMATION (Complete all sections that apply)
- REAL PROPERTY
- Description of property, i.e., address/location (attach legal
description of the property, title report, if available, and evidence of
ownership): _________________________________________________
- Name, address, and phone no. of titled owner:
_________________________________________________
_________________________________________________
- Is titled owner a fugitive? [ ] Yes [ ] No
- Name, address, phone no., and grounds for claims of all potential
claimants:_____________________________
_________________________________________________
_________________________________________________
- Type of Real Estate (check all that apply):
[ ] Single Family Detached Residence
[ ] Apartment/Condominium Unit
[ ] Apartment/Condominium Building
[ ] Commercial [ ] Undeveloped Land [ ] Other
- Specific concerns regarding the property (include apparent major
structural defects, unfinished or incomplete construction areas, etc):
____________________________________
_________________________________________________
_________________________________________________
- Is the property potentially contaminated? [ ] Yes [ ] No
- If yes, has any agency been contacted to provide contamination
assessmenton the property?
[ ] Yes [ ] No
- Is the property occupied? [ ] Yes [ ] No
- If yes, attach name, phone no., and status of all known occupants
(owner,renter, elderly, children, handicapped, pets, other)
__________________________________________
_________________________________________________
_________________________________________________
- Are contents of the house being seized? [ ] Yes [ ] No
- If no, have arrangements been made to handle unseized personal
property?
[ ] Yes [ ] No
- Is the property a historical site or proposed historical site under
federal/local law? [ ] Yes [ ] No
PREPARE NET EQUITY SHEET
(NET EQUITY WORKSHEET MUST BE ATTACHED) USAM 9-23.000
- Does the asset meet the minimum net equity threshold value? [ ] Yes
[
] No
- If no, what law enforcement benefits are to be derived from the
seizure?
__________________________________________________
__________________________________________________
- Can the losses be mitigated? [ ] Yes [ ] No
- Explain: _____________________________________
__________________________________________________
- BUSINESS
- Name of business:
_________________________________________________
- Type of business: _________________________________________________
- Is business [ ] operating [ ] idle
REAL PROPERTY/BUSINESS PRE-SEIZURE CHECKLIST
- Factors relevant to the decision to continue operating the business:
__________________________________________________
__________________________________________________
- Are business assets being seized? [ ] Yes [ ] No
- If yes, describe assets to be seized:
__________________________________________________
__________________________________________________
__________________________________________________
- Are accounts payable being seized? [ ] Yes [ ] No
- Are accounts receivable being seized? [ ] Yes [ ] No
- Is the business located in leased real property?
[ ] Yes [ ] No
- Is it located in real property owned by the business?
[ ] Yes [ ] No
- Type of ownership: [ ] Corporation [ ] Partnership [ ] Sole
Proprietorship [ ] Other, explain:
__________________________________________________
- Name(s), address(es), and phone no(s). of owner(s):
__________________________________________________
__________________________________________________
- Name, address, phone no., and grounds for claims of all potential
claimants:______________________________
__________________________________________________
__________________________________________________
- Name and location of contact person for access to business
records:__________________________________________
__________________________________________________
- State the financial condition of the business:
__________________________________________________
__________________________________________________
- Business Liabilities: $
__________________________________________________
- Net worth: $ __________________________________________________
- Indicate source, i.e.: [ ] Estimate
[ ] Balance Sheet (date: ______)
PREPARE NET EQUITY SHEET
(NET EQUITY WORKSHEET MUST BE ATTACHED) USAM 9-23.000
- Does the asset meet the minimum net equity threshold value? [ ] Yes
[
] No
- If no, what law enforcement benefits are to be derived from the
seizure?
__________________________________________________
__________________________________________________
- Can the losses be mitigated? [ ] Yes [ ] No
- Explain: _____________________________________
__________________________________________________
GENERAL INFORMATION
- AUSA Assigned:________________________________
- Phone No.:_______________
- Address: _____________________________________
- Case No. (when available):
__________________________________________________
- Agency(ies) Involved:
__________________________________________________
- Agent(s) Name: __________________________________________________
- Phone no.: ______________
- Agency Case No.: ___________
- Is there a related criminal case or investigation?
[ ] Yes [ ] No
- If yes, name of criminal case:
__________________________________________________
- Criminal AUSA assigned:
__________________________________________________
- Is sharing anticipated? [ ] Yes [ ] No
SEIZURE INFORMATION
- Date USMS Office was contacted?
__________________________________________________
- Name, phone no. of USMS contact:
__________________________________________________
REAL PROPERTY/BUSINESS PRE-SEIZURE CHECKLIST
- Pre-seizure Meeting Date:
__________________________________________________
- Scheduled Seizure Date:
__________________________________________________
- Relevant statute(s) authorizing seizure:
__________________________________________________
__________________________________________________
- Specific facts which demonstrate the existence of probable cause
that the property violated statutes authorizing civil forfeiture:
______________________________________
__________________________________________________
- Has information which will assist agents regarding their safety and
welfare been transmitted to USMS?
[ ] Yes [ ] No
- Estimated post-seizure expenses (including maintenance and
disposition):_____________________________________
__________________________________________________
- Are there any public relations concerns anticipated?
[ ] Yes [ ] No
- If yes, has the appropriate public affairs personnel been advised
or consulted? [ ] Yes [ ] No
_________________________________________________
Prepared by: Name/Title
[cited in Criminal Resource Manual 2204]
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