TD-F 93.08 Report on Blocked Property - Tangible/Real/Other Non-Fin

REPORT ON BLOCKED PROPERTY - TANGIBLE/REAL/OTHER NON-FINANCIAL PROPERTY*

(Use of this form is optional, but the information requested is required by 31 C.F.R. § 501.603)

UNITED STATES DEPARTMENT OF THE TREASURY

OFFICE OF FOREIGN ASSETS CONTROL

OMB FORM: TD-F 93.08

REPORTING INSTITUTION INFORMATION

INSTITUTION NAME
ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
CONTACT PERSON NAME
TITLE
TELEPHONE NUMBER
E-MAIL ADDRESS
DATE PREPARED

PROPERTY INFORMATION

VALUE (USD)
DATE OF BLOCKING
LEGAL AUTHORITY OR AUTHORITIES FOR BLOCKING (e.g., 31 C.F.R. Part 560)
SANCTIONS TARGET / NEXUS (e.g., name of Specially Designated National or blocked person)
DESCRIPTION OF PROPERTY
NUMBER and Type of Blocked Property (e.g., 2 airplanes, 1 Internet Protocol address, 3 vehicles, 1 house, 10 diamonds)
ADDRESS OF BLOCKED PROPERTY (i.e., physical location where blocked property is held)
PROPERTY MANAGER (OR OTHER RELEVANT CONTACT) NAME, ADDRESS, PHONE AND E-MAIL

* Complete all applicable fields and include all other relevant information in the “Additional Relevant Information” field on page 2. To report blocked financial transactions or accounts, please use the form “Report on Blocked Property – Financial”/OMB Form TD-F 93.02.

PLEASE INCLUDE A COPY OF ANY RELEVANT DOCUMENTATION (E.G., BILL OF LADING, TITLE DOCUMENTS, PROOF OF BLOCKING) AS A SEPARATE ATTACHMENT

ADDITIONAL RELEVANT INFORMATION