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2288

Request for Adoption of State or Local Seizure Form

Federal Use Only
Asset Identifier: __________________
Agency Case Number: ________________
Agency Seizure Number: _____________
Seizure Date: ______________________
Judicial District: _________________
Date Request Received: _____________

  • Request must be submitted to the federal investigative agency within 30 calendar days of State and local seizure date unless circumstances merit a waiver.
  • Federal investigative agency shall review all requests for adoptions.
  • USMS must be consulted for purposes of pre-seizure planning prior to adoption.

-----------------------------------------------------------

Name of Requesting State or local Agency:

Contact Person:

Date of Seizure:                Telephone Number:
Date of Request:

Delay Requested in Processing:
Yes ( ) Reason: ___________________________
No ( )

Criminal Case:
State ( ) Case # ____________
District Attorney Assigned:
_______________________________
Federal ( ) Case # ____________
Assistant United States Attorney:
_______________________________

Was Property Seized Pursuant to State Warrant
Yes ( ) Attach Copy No( )

State Forfeiture Action Initiated: Yes( ) No( )

If yes, explain circumstances:
_______________________________

Has a State or local prosecutor declined to proceed with forfeiture under State law? Yes( ) No( )

Has another Federal Agency been contacted and declined to proceed with this forfeiture under Federal law? Yes( ) No( )

Have you attached copies of pertinent investigative or arrest reports and copies of any affidavits filed in support of a seizure warrant? Yes( ) No( )

__________________________________________________

________________________________________

To be Completed by Federal Investigative Agency

Recommend Adoption: [ ] Adoption is in accord with general and local policy.

Decline Adoption: [ ] Reason for declination:
__________________________________________________

Investigative Agency Reviewing Official
______________ __________________ Signature Date
__________________________________________________

Immediate Probable Cause Review needed if following factors are not � present:

  • seizure was based on judicial warrant
  • arrest made in connection with seizure
  • drugs or other contraband were seized from the person from whom the property was seized

Investigative Agency Headquarters Approval:

________________________  ___________
Name/Title                Date
John Doe

[cited in USAM 9-116.110]