852. Sample Indictment—False Claim, 18 U.S.C. § 152(4)

On or about __________ , in the ___________District of_________, JOHN DOE, defendant herein, knowingly and fraudulently presented a false claim in the amount of $4,800 for proof against the estate of XYZ Company, No._____________, which sum purportedly was due for furniture sold to the debtor by the defendant JOHN DOE, when in truth and in fact, as JOHN DOE well knew, no furniture had been sold to the debtor.

All in violation of 18 U.S.C. § 152(4).

[cited in JM 9-41.001]