Attachment 8 CBP forms.PDF

03/23/2007 1 5:0 6 FAX 31729r- 1 6 NDC

DEPARTMENT OF HOMELAND SECURITY

U.S. Customs and Border Protection

VEHICLE/VESSEL/AIRCRAFT INVENTORY AND RECEIPT

1. SEIZURE NO. 7. MAKE

13. SERIAL NO. (VIN)

2. G.O. NO.

-e. moDEL

14. REGSTRATION AND LICENSE NO. (YEAR AND STATE)

3. DATE OF INVER TORY 9. COLOR 10: YEAR PCE L ( CHE-CK ONE)

U CAR LA DIESEL [] JP OTHER4, ENFORCE NO. II.. NO. CYLINDERS/ENGINES

5. INVESTIGATIVE NO. 12 ODOMETER REAEING(SPSEODMETERJHOUR METER) ENGINE SERIAL NC./NOS.

b. LOCAL NO. 17. LENGTH OF VESSEL/TRAILER (BOTH)

TYPE OF CONVEYANCE (CHECK APPROPRIATE BM

18. VEHICLE 19, VESSEL 20. AIRCRAFT

0 A. PASSENGER (BODY STILE) A. tvi01 CI: BOAT 0 A. HELICOPTER

0 8. TRACTOR _ .. B. CABIN CRUISER 0 B. FIXED WING

0 C. TRAILER C. SAIL

ril D. MOTORCYCLE 0 D. HYDRO FOIL

0 E. MOTORSCOOTER 0 E. OTHER

—0 F. BUS (PASSENGER CAPACITY)

EGLI PMENT EQUIPMENT 'EQUIPMENT

D RADIO LI LITERATI 0 OXYGEN

0 POWER ST EERING RADIO SCANNTER - 0 PRESSURiZATiON

U AR CONDM ONE R

i-,-, rj DEPTH ENDER il LOG BOOKS

Li AU1 MAT IC TRANSMISSI ON 0 ENGINES AIR FRAMES

KEYS D LIFE jAOKETS I HOW MANY? a ENGINES

21 SPECIAL EQUIPMENT (VESSEL/AIRCRAFT) NUMBER OF WHEELS

BRAND AND SEE NITRESTYPE REIMER MAKE MODEL

VHF

FE 24, CONDITION OF CONVEYANCE (NOTE DAMAGE, DENTS, ETC., ANY OFFER DEPECIS AT

THE EWE OF SEIZURE - BODY, MOTOR, TIRES, PAINT AND INTERIOR. GIVE GENERAL

DESCRIPTION)

DIE

C3

MARINE

ADE

DME

RADAR

COMPASS

TRANSPONDER

OTHER

REGISTERED OWNER NAME: ADDRESS: -I

PERSON FROM *-10M SEIZED NAME:

ADDRESS:

27, UENHCLDER NAME: ADOP.ESS:

28. VIOLATION WHICH SEIZED: 1 29. SEIZURE COST: I 30. DATE SEIZED:

31. SEIZING OFFICER WW1 TITLE:

22 INVENTORY OFFICER NAME: TITLE: SIGNATURE: X

33. GARGAGE/STORAGE FACILITY

NAME: ADDRESS:

RATE OF STORAGE:

DATE STORED:

PERSON RECEIVING

CONVEYANCE AT GARAGE/

STORAGE FAC,I_TTY

NAME: TITLE: SIGNATURE

X

DATE RECD

CBP FOTTI 58 (03/04)

MAR-23-2007 02: 1SPM FAX: 3172907046 ID: PAGE: 001 R=96

Initial Screening

Secondary Screening

SEIZED VEHICLE INSPECTION WORKSHEET

— This worksheet is to be completed by Supervisory Personnel only"

Part 1 Date/Time of Seizure Case Number: #

Vehicle: Year: Make: Model: License Number:

Vehicle: Year: Make:

Model:

License Number:

(If applicable - use for tractor/ trailer combinations)

Part 2

7-POINT INSPECTION

Inspector Completing Exam:

Certifying Supervisor:

Supervisor's Signature:

CANINE SCREENING

CEO/Canine Completing Exam:

Certifying Supervisor:

Supervisor's Signature:

Printed Name

Date

Printed Name of Handler and Canine

Printed Name Date

NON-INTRUSIVE INSPECTION (NII)

Inspector Completing Exam:

Pr need Name

Certifying Supervisor:

Printed Name

Supervisors Signature: Date

FIBER OPTIC INSPECTION (GAS TANK)

Inspector Completing Exam:

Printed Name

Certifying Supervisor:

Prieed Name

Supervisors Signature: Date

CERTIFICATION OF COMPLETION AND RELEASE

All above items MUST be completed within 24 hours of seizure and prior to releasing the vehicle from CBP custody. (i.e. release to the seized property contractor, outside agencies, return to violator, etc.)

Part 3

FINAL CANINE SCREENING PRIOR TO AUCTION OR RELEASE

CEO/Canine Completing Exam: Date:

Printed Name of Hanalei and Canine Badge it

Contraband Type:

Part 4

COMPLETE FOR POSITIVE RESULTS

(Complete only for results from final canine exan or any re-screening)

Contraband Weight: Date Found

Location(s) In Vehicle Found:

Distribution: Original with NII Image-FPF File and copy for SPS File

Copy (No Nil - Contractor)

Badge

Badge t/

Badge #

Badge It

Badge a

Badge C

Badge 3(

Badge it

Revised 0771212007

03/23/2007 15:06 FAX 3172903 NDC 001

U.S. Customs and Border Protection

VEHICLEIVESSELIAIRCRAFT INVENTORY AND RECEIPT

p. SEIZURE NO. 7. MAKE 13. SERIAL NO. (vIN)

9.. G.O. NO. 8. MODEL 14. REGSTRATION AND LICENSE NO. (YEAR AND STATE)

3. DATE OF INVEN TORY 9. COLOR I 10; YEAR 15, FUEL ( CHECK ONE)

[_] SAS L1 DIESEL U JP OCTHER4, ENFORCE NO.

NO. CYLINDERS/ENGINES

5. INVESTIGATIVE NO ODOMETER READING (SPEEDOMETER/HOUR METER) ENGINE SERIAL NC.INOS.

5. LOCAL NO. LENGTH OF VESSLBJTHAF_ER (BOTH)

TYPE OF CONVEYANCE (CHECK APPROPRIATE BOX)

18. VEHICLE . 19. VESSEL

6J. AIRCRAFT

0 E. MOTDRSCOOT ER 0 E. OTHER

0 F. BUS (PASSENGER CAPACITY)

[1] G. TRUCK (BODY STYLE & MPG. RATED CAPACITY)

H. OTHER

EQUIPMENT ETIPMENT 'EQUIPMENT

Ei. RADIO 11 I IFER.AF1 OXYGEN

0 POWER ST EEPJNG RADIO SCANNER 0 PRESSURIZATION

AJR CONDMONER DEPTH FINDER 111 LOG BOOKS

1—,._, 0 AUTOMATIC TRANSMISSION ENGINES D AIR FRAMES

KlYS D LIFE JACKETS j HOW MANY? U P.NGNES

OTHER (SUN ROOF, 03, TAPE DECK, ETC.) Li OTHER WEIGHT/BALANCE

0 OTHER

21 SPECIAL EQ UIPMENT (VESSEL/AIRCRAFT) NUMBER OF WHEELS

BRAND AND SIZE OF TIRESTYPE NUMBER MAKE MCDEL

VHF

RE 24. CONDITION OF CONVEYANCE (NOTE DAMAGE, DENTS, ETC., ANY OTHER DEFECTS AT

THE ME OF SEIZURE— BODY, MOTOR, TIRES, PANT AND INTERIOR. GIVE GENERAL

DESCRIPTION)

UHF

CB

mcine

ADE

DOE

RADAR

COMPASS

TRANSPONDER

OTHER

REGISTERED OWNER NAME.: ADDRESS:

PERSON FROM 01,101V SEIZED NAM:: ADDRESS:

LIENHOLDER NAME: . ADDRESS: •

VIOL/DON WHICH SEIZED: 1 29, SEIZURE COST: I 30, DATE SEIZED:

SEIZING OFFICER NAST: TITLE:

INVENTORY OFFICER NAME: TITLE: SIGNATURE: X

33. GARGAGEJSTORAGE FACILITY

NAmE: . ADDRESS: RATE OF STORAGE:

DATE STORED:

PERSON RECEIVING

CONVEYANCE AT GARAGE/

STORAGE FAOLITY

NAME: TITLE: SIGNATJRE:

X

DATE REC'D:

CBP Fo rm 58 (03/04)

MAR-2-200T : 18PM FAX: 3178903046

ID: PAGE:0AI R=967:

U.S. DEPARTMENT OF HOMELAND SECURITY

Bureau of Customs and Border Protection 3071918

CUSTODY RECEIPT for SEIZED PROPERTY and EVIDENCE

Handbook 5200-09 2 Incident No1i: PF No

1 I II II Iril Ii I DrirlF HririI 1 riirli [1111 PT-1

3. Investigative Case No.

5. Prior Detention?

YesLjJ No El

9. Seized From:

Name:

Address:

ril II II

[in 11111___IFI-1

If yes, CBP 6051D No.

LII

Enforce No.

L_JI PH

6. Date Seized (mmidd/yyyy)

/ I

10 Entry No

I I

12 Remarks:

7 Time Seized (Use 24 His) 8 FDIN/Misc

I 11 Seal or Other ID Nos

Telephone No. (j Ext:

13 Send Correspondence to.

14. PROPERTY ( By Line Item) Attach CBP 58 if conveyance

t $ -1, i

4 ----

$ 1 ._.,4

$ i

15 Seizing Officer X

Si

Print Name nature Late

16. ACCEPTANCE / CHAIN OF CUSTODY

b. Description c. Print r- d. Signature

Name/Title/Organization e Datea. Line

:tern No.

CBP Form 6051A Continuation Sheet Attached? Yes El No fl i

CBP Form 6051S (03/04)

CBP Retains Original

U.S. Customs and Border Protection

ORDER TO DESTROY AND RECORD OF DESTRUCTION OF FORFEITED,

ABANDONED, OR UNCLAIMED MERCHANDISE

ORDER TO DESTROY

Seizure or General Order No., Etc. Quantity and Description of Merchandise

Method of Destruction

Authorizing CBP Officer X

Date

Name Signature

RECORD OF DESTRUCTION

CBP Officer

X Date

Name Signature

Witness to Destruction X

Name Signature

Witness to Destruction X

Name Signature

Location Method of Destruction

CBP Form 4613 (09/04)

U.S. Customs and Border Protection

CBP OFO OBP E

DISPOSITION ORDER

Tc-96-001, Tc-01-032

ICE q IRS USSS q USCG E OTHER

El Contractor

E Seizing Agency

1. SEACATS Seizure Case No. 2. Agency Tracking No. 3. Date

4. DISPOSITION INSTRUCTIONS:

SELL q TRANSFER q DESTROY MANIPULATION

4613 (Complete Block 6) Destroy k 6Blockoc) OTHER (Complete Block 6)

U REMIT

OwnerNiolator I Export Only • To Treasury Agent Attach CBP

Lien Holder • Interlocutory • State & Local Law (Complete

(Complete Blocks 6 & 7) • Court Directed Enforcement Agency

ASSET SHARING

(Complete Block 6) n Donation to Charitable Institution (Complete Blocks 6 & 7)

(Please Print)

FP&F Officer or Other Authorized Agency Representative

X

Contractor Office Telephone Number Signature

5. IDENTIFICATION OF PROPERTY:

7 Only sub-line items listed below All items in seizure Only line items listed below Partial line item quantity listed below

Line Item No. Description Unit of Measure Quantity

SPECIAL INSTRUCTIONS: Waive all costs q Waive SCA only - Reason:

RELEASE PROPERTY

Name of Agency/Organization:

Name of Individual:

Address (City, Caution: Property will of authorization

TO:

Telephone No.

State, Zip Code):

be released ONLY to person named in Block 7 unless an agent is authorized. Approved agents must have proof of identification and a letter from person identified in Block 7.

Remit n Sell n Transfer • Destroy n Manipulate Other Drivers License or Passport Number:

DISPOSITION

Date Accomplished:

ACCOMPLISHED:

Charges Paid $ Sale Price Received $

(Print) Subcontractor Name Signature (Print) Person Receiving Property Name Signature

(Print) Contractor Name Signature (Print) Seizing Agency Representative Signature

CONTRACTOR/SEIZING AGENCY REPRESENTATIVE AUTHENTICATION:

(Print) Name and Title Signature Date

INSTRUCTIONS TO OWNER/LIEN HOLDER: This property is in the custody of the U.S. Customs and Border Protection seized property contractor. Reimbursement of costs incurred by the Seizing Treasury Agency for property management services is required. These charges must be paid by cash or cashier's check. All cashier's checks must be made payable to (Check one)0 "Department of the TreasuryNSE Agent," or q "Rod Robertson Enterprises, Inc." NOTE: Anyone acting, as an agent of owner/lien holder must have proof of identity and letter of authorization to claim the property. Personal checks, business checks or money orders are not acceptable.

Original - Issuing Seizing Agency/Office Case File Canary - Contractor File Pink - Person Recieving Seizure (Remittance, Transfers & Donation);

Goldenrod - Agency Suspense

CBP Form 7605 (12/07)

PROPERTY IN CONTRACTOR CUSTODY-USE OF DISPOSITION ORDER

Instructions to Seizing Agency Officer

Block 1 - SEACATS Seizure Number Enter the SEACATS generated seizure number also referred to as the FP&F Case Number.

Block 2 - Other Agency Tracking Number Enter the other agency tracking number, also referred to as the AFTRACK number or other agency case number.

Block 3 - Date

Block 4 - Disposition Instructions Check the appropriate box. Orders to destroy must be accompanied by CBP Form 4613 or other agency order to destroy. Manipulations or other request are ordered by checking the appropriate block and completing Block 6 with specific instructions.

Block 5 - Identification of Property When disposition instructions do not apply to all line items in a seizure, check the "Line Item" box or "Partial Quantity" box, as applicable, and prepare separate CBP Form 7605, Disposition Orders for remaining line items as appropriate.

Block 6 - Special Instructions Use this space to indicate special instructions regarding waiving all or partial holding costs, conditions of release, manipulations, procedures for supervision/documentation/prior notification of exportations/ destructions, etc.

Block 7 Release Property To Indicate the name and address of the individual, company, institution, agency, or authorized agent to whom the property is remitted or transferred. For retained property indicate the name of the receiving Treasury Agency office.

For walk-through remissions and transfers (recipient physically present), hand original to the owner/lien holder/ agent/transferee AFTER report particulars to the Contractor Office. For other transactions, mail original to the Contractor Office. Original is returned to the Issuing Seizing Agency Office after disposition is accomplished.

Instructions to Contractor (Vendor)

Block 8 Disposition Accomplished Remit/Transfer - Person releasing property is to indicate date of release, drivers license or passport number, amount of changes paid by person receiving property and obtain signature of recipient.

Destroy - Subcontractor performing the work certifies disposition accomplished, obtains signature of contractor official and, when required, the Seizing Agency Representative.

Sell/Other/Manipulation - When an "Other" disposition or "Manipulation" is accomplished, contractor or subcontractor signs and obtains, if required, signature of Seizing Agency Representative. When property is sold, contractor sale manager will print name and sign over subcontractor block, indicate sale price received and date.

Block 9 Authentication Signed by contractor or Seizing Agency Representative, original is returned to issuing Seizing Agency Office.

CBP Form 7605 (Back)(12/07)

OTCnet DEPOSIT TICKET

MAILED TO BANK LOCATION CODE(ALC)

(1) 113263 (2) 12-14-05 (3) (4) 1,200.00

(6) AGENCY USE

Customs and Border Protection

Buffalo, NY

726 Exchange Street

Suite 400

Buffalo,NY 14210

US

Concord, CA

(7) NAME AND ADDRESS OF DEPOSITORY

Bank of America

C

US

THERIN.

MMDDYY

AUTHORIZED SIGNATURE CONFIRMED DATE

ORIGINAL

Checks and Money Orders Subtotal $ 0.00

Paper Currency Count Value

*1.00 , 0.00

$2.00 . 0.00

105.00 0.00

$10.00: 0.00

$20.00 . 0.00

♦50.00. 0.00

0100.00 12 1,200.00

Paper Currency A 1,200.00 Coin Currency Subtotal : $ 0.00

Subtotal.

Currency Subtotal $ 1,200.00

Deposit Total . * 1,200.00

RTN s

DDA A

https://www.oteneLfms.treas.gov/otcnet/deposits/depositTicketjsi?depositld=13683 5/26/2011