TD-F 93.09 Report of Russian Sovereign Assets Form

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Overview

Part A
Part B

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Sheet 1: Part A

REPO Report Form
			OMB No. 1505-0164
	REPORT OF RUSSIAN SOVEREIGN ASSETS UNDER THE REBUILDING ECONOMIC PROSPERITY AND OPPORTUNITY FOR UKRAINIANS ACT UNITED STATES DEPARTMENT OF THE TREASURY OFFICE OF FOREIGN ASSETS CONTROL
	Part A - U.S. Person Holding Russian Sovereign Assets
	(1) Enter the name and address of the person (e.g., specific financial institution) holding the Russian sovereign asset.
		Name:	<Enter Detail Here>
		Address:	<Enter Detail Here>
		City:	<Enter Detail Here>
		State:	<Enter Detail Here>
		Postal code:	<Enter Detail Here>
		Country:	<Enter Detail Here>
	(2) Enter the contact details for the individual from whom additional information may be obtained.
		Name:	<Enter Detail Here>
		Title:	<Enter Detail Here>
		Telephone #:	<Enter Detail Here>
		Email:	<Enter Detail Here>
		Date prepared:	<Enter Detail Here>
	(3) Enter the total quantity of accounts or items reported in the Part B tab:		<Enter Detail Here>
	Please note that the total quantity of accounts or items reported in section (3) must equal the total number of rows containing Russian soverign assets in the Part B tab.
	Instructions for the Part B tab
	Identify each account or item of Russian sovereign assets separately in the rows provided in the "Part B" tab. Be sure to indicate the total number of accounts or items reported on Part B in the appropriate space on Part A. Basic details regarding certain information requested in Part B are noted below. Pursuant to section 2 of the Rebuilding Economic Prosperity and Opportunity for Ukrainians Act, the term “Russian sovereign asset” means any of the following: (A) Funds and other property of (i) the Central Bank of the Russian Federation, (ii) the Russian National Wealth Fund, or (iii) the Ministry of Finance of the Russian Federation; or (B) any other funds or other property that are owned by the Government of the Russian Federation, including by any subdivision, agency, or instrumentality of that government. Financial institutions may rely on reports regarding Russian sovereign assets located at the financial institution that are filed pursuant to Directive 4 under E.O. 14024 or in reports of blocked property filed pursuant to 31 C.F.R. § 501.603(b) to fulfill their obligations under section 104(a) of the Act with respect to those assets and should not re-report to OFAC any such assets under this instruction. Reports provided under this instruction shall identify Russian sovereign assets not otherwise reported to OFAC pursuant to Directive 4 under Executive Order 14024 or in reports of blocked property filed pursuant to 31 C.F.R. § 501.603(b).
	Date of Detection Blocking	The date the Russian sovereign asset was detected.
	Value (USD)	Provide the actual or estimated value of the property in U.S. Dollars as of the date of dection.
	Legal Authority or Authorities	REPO Act Report
	Owner of Property	The person who legally owns the account or other property.
	Owner Type	Please indicate the owner type using the following categories: individual; U.S. bank; non-U.S. bank; U.S. non-bank entity; non-U.S. non-bank entity; or other.
	Description	A brief but comprehensive description of the Russian sovereign asset(s), including: • Asset Type (e.g., Bank account, check, wire transfer, stocks, real estate, tangible property) • Account Type (e.g., checking, savings) • Account Number (if applicable for financial assets)
	Location (city and country)	List the location or branch where the property is held, if different from the address shown in Part A.
	PAPERWORK REDUCTION ACT NOTICE Public reporting burden for this collection of information is estimated to average two hours per response. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information to the Office of Foreign Assets Control, U.S. Department of the Treasury, 1500 Pennsylvania Avenue, N.W., Freedman’s Bank Building, Washington, DC 20220.
TD-F 93.09

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Sheet 2: Part B

Date of Detection

Value (USD)

Legal Authority or Authorities

Owner of Property

Owner Type

Asset Type

Account Type(s)

Account Number(s)

Additional Description of the Property (if needed)

Location: City

Location: Country