Form TD F 92-22.46 TD F 92-22.46 Request for Transfer of Property Seized/Forfeited by a T

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OMB No. 1505-0152

DEPARTMENT OF THE TREASURY
Request for Transfer of Property Seized/Forfeited by a Treasury Forfeiture Fund Participating Agency

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All assets transferred must be used for the law enforcement purpose stated in this request.
The deadline for submission of this request is sixty (60) days following the seizure of the
asset requested.
The requesting agency will be responsible for reimbursing the Treasury Forfeiture Fund
(TFF) its costs.

I. Seizing Agency (For Treasury Forfeiture Fund Participating Agency Use Only)
Seizure Number:_________________________
Seizing Agency: _______________
Case Number: ___________________________
SAC Office: __________________
Case Type: Adoption________ Joint ________
Seizure Date: _________________
_____________________________________________________________________________
II. Requesting Agency
Agency Name: _______________________________ NCIC Code: __________________
Address: __________________________________________________________________
Contact Person: ____________________________________________________________
Telephone Number: ______________________
Email: _______________________
Finance/Budget Contact (regarding share deposit): ______________________________
Telephone Number: _______________________
Email: _______________________
______________________________________________________________________________
III. Asset Requested (If requesting more than one asset, please attach list)
Description: _______________________________________________________________
Percentage Requested: ________
Is this a non-monetary asset that will be placed into official use?
Yes No
______________________________________________________________________________
IV. Specific Intended Law Enforcement Use (for requested funds):
__ Salaries
__ Purchase of Vehicles
__ Purchase of Equipment
__ Other (Explain) _________________________________________________________
______________________________________________________________________________
V. Contribution (For all “yes” answers, provide details in part VI)
A. Did your agency originate the information leading to the seizure?
B. Were any other assets seized under state law?
C. Were extraordinary expenses incurred?
D. Did your agency supply any unique or indispensable assistance?
E. Are there any assets located in foreign countries?
F. How many hours were expended? __________

Yes
Yes
Yes
Yes
Yes

No
No
No
No
No

______________________________________________________________________________
TD F 92-22.46 (9/11) PREVIOUS VERSIONS OBSOLETE

VI. Summary of Agency Participation (and explanation of items in prior section as
necessary)

(If more space is needed, please use and attach a separate sheet of paper)
VII. Certifications
A. The requesting agency certifies that the above information is true and accurate, that the
property transferred will be used for the law enforcement purpose stated, and that all
monies received pursuant to this request will be deposited and accounted for in a manner
that is consistent with applicable Federal, State, and local law, regulations and orders. The
requesting agency agrees to report on the actual use of equitably transferred property upon
request. The requesting agency understand that if it is unable to pay the necessary fees
and expenses at the time of transfer, the asset may be sold and a percentage of the net sale
proceeds will be awarded in lieu of the asset.
Name: ____________________________________ Title: _________________________
Signature: _________________________________ Date: _________________________
B. As legal counsel, I have reviewed this request and I certify that the contact person
identified in Part II has the authority to accept seized/forfeited property and is the official
to whom transfer documents and/or money should be delivered. (Legal counsel
certification is not required for Federal law enforcement agencies)
Name: ____________________________________ Title: _________________________
Signature: _________________________________ Date: _________________________
Address: _________________________________________________________________
Telephone Number: _______________________________
______________________________________________________________________________
TD F 92-22.46 (9/11) PREVIOUS VERSIONS OBSOLETE