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Federal Equitable Sharing Agreement
"VALID THRY SWTKMBER 30, 2002" �
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Law Enforcement Agency: ) 0Check%[NewParuc4oant
O Police Department SherifTsofHce/Department lO TaskFoQONTRACT
OProsecutor's Office O Other
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Contact Person: C�ti-�.i��- ����- ��I �� E-mail Address: Ll.'_ )
Mailing Address: )'))/7/
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(City) (stale) (zip Code)
Telephone Number: ( ())( ) C� ��, �(,i` Fax Number: ! ` -' 1 ,J
Agency Fiscal Year Ends on: 3) NCIC/ORI/Tracking No.: l- i
(Month/Day)
This Federal Equitable Sharing Agreement entered into among(1)the Federal Government,(2)the above-stated law erif rcement agency,
and(3)the governing body sets forth the requirements for participation in the federal equitable sharing program and the restrictions upon
the use of federally forfeited cash,property,proceeds,and any interest earned thereon,which arc equitably-shared with participating law
enforcement agencies.'By their signatures, the parties agree that they will be bound by the statutes and guidelines that regulate shared
assets and the following requirements for participation in the federal equitable sharing program.
1. Submission. The Federal Equitable Sharing Agreement a9d the Federal Annual Certification Report must be inbraitted.to both
the Department of Justice and the Department of the Treasury with a copy provideg to the U.S.Attorney in thc district in which
the recipient law enforcement agency is located,in accordance with the instructions received from the respective departments or
as outlined in their equitable sharing guidelines.
Asset Forfeiture and Money Laundering Section Executive Office for Asset Forfeiture
U.S.Department of Justice/ACA Program U.S.Department of the Treasury
P.O.Box 27768 74015th Street,N.W.,Suite 700
Washington,D.C. 20038 Washington,D.C. 20220
E-mail address: prograrrLaca@usdoj.gov E-mail address: treas.aca@teoa£trru>.gov
Far:(202)616.1344" Fax:(202)622-9610
2. Signatories. This agreement must be signed by the head(or authorized representative)of the law enforcement agency and
the head(or authorized representative)of the governing body. Receipt of the signed agreement is a prerequisite to receiving
any equitably-shared cash,property, or proceeds.
3. Uses. Any shared asset shall be used for law enforcement purposes in accordance with the statutes and guidelines that govern
equitable sharing, and as specified in the equitable sharing request(either a DAG-71 or a TD F 92-22.46) submitted by the
requesting agency. Any and all requests for a change in the use of cash, property, or proceeds from that specified in the
equitable sharing request must be submitted in writing to the appropriate agency shown in item 1.
4. Transfers. Before the undersigned law enforcement agency transfers cash,property, or proceeds to other law enforcement
agencies,it must verify first that the receiving agency has a current and valid Federal Equitable Sharing Agreement on file with
both the Department of Justice and the Department of the Treasury. If there is no agreement on file, the undersigned law
enforcement agency must obtain one from the receiving agency,and forward it to the appropriate department showtm in item 1.
A list of recipients, their addresses,and the amount transferred must be attached to the Federal Annual Certification Report.
S. Internal Controls. The parties agree to account separately for federal equitable sharing funds received from the Department
of Justice and the Department of the Treasury. Funds from state and local forfeitures and other sources must not be commingled
'Attach list of member agencies with their addresses and indicate lead agency.
u1111, u:: VM1 14: 42 KU LU2h I 1344 tAUlll.lr
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with federal equitable sharing funds. The recipient agency shall establish a separate revenue account or a;coutttlng code for
state, local, Department of Justice, and the Department of the Treasury forfeiture funds. Interest income generated must be
deposited in the appropriate federal forfeiture fund account.
The parties agree that such accounting will be subject to the standard accounting requirements and practices employed for other
such public monies as supplemented by requirements set forth in the current edition of the Department of Justice's A Guide to
Equitable Sharing of Federally Forfeited Property for State and Local Law Enforcement Agencies (Justice Guide), and the
Department of the Treasury's Guide to Equitable Sharing for Foreign Countries and Federal, State, and Local Law
Enforcement Agencies(Treasury Guide). The accounting of shared funds must be submitted in the format shown on the Annual
Certification Report contained in both the Justice and Treasury Guides.
The misuse or misapplication of shared resources or the supplantation of existing resources with shared assets is prohibited.
Failure to comply with any provision of this agreement shall subject the recipient agency to the sanctions stipulated in the current
edition of the Justice or dreasury Guides, depending on the source of the Ands or property.
6. Federal Annual Certification Report. The recipient agency shall suhmit an Annual Certification Repor to the Department
of Justice and the Department of the Treasury (at die addresses shown in item 1) and a copy to the U.S. Altos ney in the district
in which the rccipientagency is located. The certification must be submitted in accordance with the instructions received from the
respective departments or as outlined in the Justice or Treasury Guides. Receipt of the certification report is a prerequisite to
t receiving any equitably-.shared cash,property, or proceeds.
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7. Audit Report. Audits will be conducted as provided by the Single Audit Act Amendments of 1996 and OMB Circular
A-133. The Department of Justice and the Department of the Treasury reserve the right to conduct periodic random audits.
During the past 3 years,has your agency been found in violation of,or entered into a settlement agreement-`pursuant
to, any nondiscrimination law in federal or state court, or before an administrative agency?
0 Yes (A No (If you answered yes,attach relevant information. See instructions.)
Are there pending in a federal or state court,or before any federal or state administrative agency,proceedings against
your agency alleging discrimination?
OYes Q No (If you answered yes, attach relevant information. See instructions,)
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The undersigned certify that the recipient agency is in compliance with the nondiscrimination requirements of the
following laws and their Department of Justice implementing regulations: Title VI of the Civil Rights Act of 1964
(42 U.S.C.§2000d etseq.),Title IX of the Education Amendments of 1972(20 U.S.C.§ 1681 etseq.),Section;ip4 of the
Rehabilitation Act of 1973(29 U.S.C.§794),and the Age Discrimination Act of 1975(42 U.S.C. §6101 etseq.),which
prohibit discrimination on the basis ofrace,color,national origin,disability,or age in any federally assisted program or
activity, or on the basis of sex in any federally assisted education program or activity,
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Under penalty of perjury,the undersigned officials certify that the recipient state or local law enforcement age'ney is in compliance with the provisions of the Justice and/or Treasury Guides and the National Code of Professional Conduct
for Asset Forfeiture.
I -Name (Prtnt or Type)
Date Name (Print or Type)Law Enforcement 'Agency Head or Authorized Representative Governing Body Head or Authorized Representative Dare
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(Signature)
(Signature) '
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A.�C
Tide (Pon[ or Type) -
Title (Print or Type)
This form is subject to the Freedom of/nformation Act and may be released to requests under 5 U.S.0 g 552,
01,'11/02 FRI 14:43 FAX 2026161344 OADA1JP
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Federal Annual Certification Report p-Hra
This Annual Certification Report most be submitted within 80 days after the close of your fiscal year to both agoncler:
U.S.Department at Justice/ACA Program0
U.S.Department of me Treasury ar---C
Asset Forfeiture and iMoney Laundering$edron Executive ORice for Assel Forfeiture
POB 27768 740 14Ih Street,N.W.,Suite 700
Washington, D.C. 20038 Washington, D.C. W.,S
E-mail add02)616:pragram.aca®usdoj gov E-mail address: heas.aca@teoaf.treac.gov
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Fax (202)818-136a Far (202)622-9610
Law Enforcement Agency:
0 Police Deparonent (9-Sherif's OtrmelD ent —epa � Tuk Farce' Pmsecumi s office �) Omer
Contact Person: \ C, -�Z t ) _ —
- _ 1�` _ E-msllAddress:
Mailing Address:
(Snecq /IC (star) (zip Code)L
Telephone Number. Fax Number:
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Agency Fiscal Year Ends on: 1 =Zl_-. -._. NCICIORIfTraekfn No.: C.0
(MOn1WUsy/Year) -- - -
F Summary of Equitable Sharing Activity
Justice Funds Treasury Funds
I. Beginning Equitable Sharing Fund Balance $
2. Federal Sharing Funds Received $
3. Otherincome $_ $
4. Interest Income Accrued
5. Total Equitable Sharing Funds(total of lines I-4) $ $
6. Federal Sharing Funds Spent(total of lines a-I)
7. Equitable Sharing Fund Balance(subtract line 6 from line 5) $ $
8. Appraised Value of Other AsselsReceived $ $
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Summary of Shared Monies Spent
a. Total spent on salaries for new,temporary,not to exceed I-year employees
b. Overtime $ ( $
c. Total spent on informant and"buy money" $_ $—
d. Total spent on travel and training $ $
e. Total spent on communications and computers S _ $
f. Total spent on firearms and weapons $ $
g Total spent on body armor and protective gear $ $
h. Total spent on electronic surveillance equipment $ $
i. Total spenton building and improvements S $ f
j. Total spent on other law enforcement expenses(attach list) $_ $
k. Total transfers to other law enforcement agencies(attach list of recipients)
I. Total permissible use transfers(attach list of recipients) S $
in. Total annual law enforcement budget foryourjurisdiction for current fiscal year-
n. Total annual budget for non-law enforcement agencies for current fiscal yeas.. __.,_ 7 $
o. Totalannual law enforcement budget for yourjurisdiction for prior fiscal yeaL___
p. Totalannual budget fornon-lawenforcement agencies for prior fiscal year_. _,_.._.______ _ " $ N•>Zi 3- 4a_Lte' .
Onder he penalty of perjury,the undersigned hereby certify that the infomndon in this report is an accurate accoutering of funds received and spent by the law enl c m ment agency under the
federal equinble sharing program during this reporting period.
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Name t Type)L Enforcement
Date Name(Pont or Type) — Date
Law Efnfordement Agency Head or Aplhorized Representative Cows ink Body Read w Authorized Representative
(signature) (Signature) r
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Li16114
Title(Print or Type) Tide(Print or Type) .1
Attach list of member agencies with their addresses and indicate lead agency.
This(orm is subject to the Freedom of Inlbrmation Act and may be released to requests under 5 US C§552, % �)