UNITED STATES DISTRICT COURT
DISTRICT OF VERMONT
UNITED STATES OF AMERICA
V. File No. 1:03-CR-35-01
PETITION OF [name of Petitioner] FOR ADJUDICATION
OF INTEREST IN [name property Petitioner has an interest in]
Petitioner [name] hereby petitions the Court pursuant to 21 U.S.C. § 853(n)(2) to assert a legal interest in [name property] which has been ordered forfeited to the United States referred to in this Court’s February 2, 2006 Preliminary Order of Forfeiture and requests a hearing to adjudicate the same. The nature and the extent of Petitioner’s right, title and interest in the forfeited property and the time and circumstances of its acquisition of that right, title and interest are set forth in the Petition and supported by the attached exhibits.
2. [state facts supporting the petitioner’s claim and the relief sought]
3. The nature and extent of the Petitioner’s right, title and interest is that of [first lienholders or bona fide purchasers for value of, the property].
WHEREFORE, Petitioner prays that this Court amend its Preliminary Order of Forfeiture entered in connection with the [property] and enter its Order restoring such ownership in the [property] to the Petitioner.
I declare under penalty of perjury that the foregoing is true and correct.
Date [Petitioner’s name, address & phone number]
Sworn to and subscribed before me this _____ day of _______, 2006.
My Commission Expires: ________