Form 92-22.46 - Request For Transfer Of Property Seized/forfeited By A Treasury Forfeiture Fund Participating Agency Page 2

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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

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