Form IndictmentEmbezzlement and Theft From an
Employee Pension or Welfare Benefit Plans or a Fund Connected With Such
(18 U.S.C. 664)
THE GRAND JURY CHARGES:|
That on or about (date) in the ____________ District
__________ the defendant, _______________________, did embezzle, steal and
unlawfully and willfully abstract and convert to his/her own use [and the
another] in the approximate amount of $_________, the moneys, funds,
premiums, credits, property and other assets of (name of plan) [an
employee welfare benefit plan] [an employee pension benefit plan] subject to
Title I of the Employee Retirement Income Security Act of 1974* and of a
connected** with such plan.
All in violation of Title 18, United States Code, Section 664.
* 29 U.S.C. 1001-1145; see definitions at 29 U.S.C. 1002 and 1003;
employee benefit plans are omitted from coverage including plans which
or state governments fund or administer for their employees.
** See United States v. Blood, 806 F.2d 1218 (4th Cir. 1986),
discusses theft from a trust fund managed by a third party administrator and
connected with several welfare benefit plans maintained by different
[cited in USAM 9-133.010]