usm623a.pdf

Form USM-623A Rev. 11/14

INTERIOR CONDITION

Front Carpet

Rear Carpet

Front Seat

Rear Seat

Door Panels

Trunk

Headliner

TornGood Stained

Good Torn Stained

TornGood Stained

Good Torn Stained

StainedTornGood

U.S. Department of Justice United States Marshals Service Asset Forfeiture Division - Intake Inspection Checklist

Date and Time of Delivery:Location of Delivery:

Asset ID # (CATS ID):District Office: Vehicle Year:

Color:Model (including XL, XLT, LS, etc.):Make:

License Plate #:VIN: Operable? Keys?Yes No Yes No

State of Registration:Model of Tires:Make of Tires:

Yes NoHidden Compartment? If yes, location:

Current Vehicle Mileage:

TRANSMISSION

ENGINE # of Cylinders:

POWER

STEERING

DOORS

SEATS

ROOF

STEREO

OPTIONS

WHEELS

4-Wheel DriveManualAutomatic

Diesel

CruiseTelescopicTiltPower A/C: Yes No

Other:Hatchback432

Other:BrakesDoor LocksSeatsWindows

Other:

ClothVinylLeather3rd SeatBenchBucket

Convertible CanvasVinylPower SunroofT-TopHardtop

Tape PlayerCD ChangerCDAM/FM Radio

Other:Custom Stereo No StereoFactory Stereo Brand:

Customized Rims

DVDTVAlarm SystemHeated SeatsNavigation

Custom WheelsFactory WheelsSpoke WheelsHubcaps

CNG

EXTERIOR CONDITION IDENTIFICATION CODES

D = Dented CR = Cracked S = Scratch FT = Flat Tire M = Missing BE = Bent L = Loose C = Cut PC = Paint Chip R = Rust DR = Damaged Rim B = Broken

Comments/Additional Notes:

INSTRUCTIONS: This form is to be utilized by the contractor or District Office only when the Investigative Agency delivers a vehicle to the contractor facility and should be used in place of the USM-623 Standard Tow Ticket. This form should also be used for vehicles stored under a Seized Property Custodial Agreement. A copy of this form should be placed in the case file.

Yes NoSpecialty Rims? If yes, make and model:

PHOTOGRAPHS

Front Back

Driver side Passenger side

Interior to include Dashboard

VIN

Any Damage (if applicable)

Dash

Mileage

Stereo/Electronic/Aftermarket/Upgraded Equip.

Electric

Form USM-623A Rev. 11/14 ..\USM-623 AFD Standard Tow Ticket\VehicleDiagram.jpg

INTERIOR CONDITION

Front Carpet

Rear Carpet

Front Seat

Rear Seat

Door Panels

Trunk

Headliner U.S. Department of Justice United States Marshals Service Asset Forfeiture Division - Intake Inspection Checklist Operable?

Keys?

Hidden Compartment?

TRANSMISSION

ENGINE # of Cylinders:

POWER

STEERING

DOORS

SEATS

ROOF

STEREO

OPTIONS

WHEELS

A/C:

EXTERIOR CONDITION IDENTIFICATION CODES

D = Dented CR = Cracked S = Scratch FT = Flat Tire M = Missing BE = Bent L = Loose C = Cut PC = Paint Chip R = Rust DR = Damaged Rim B = Broken INSTRUCTIONS: This form is to be utilized by the contractor or District Office only when the Investigative Agency delivers a vehicle to the contractor facility and should be used in place of the USM-623 Standard Tow Ticket. This form should also be used for vehicles stored under a Seized Property Custodial Agreement. A copy of this form should be placed in the case file.

Specialty Rims?

PHOTOGRAPHS

Dash