Kentucky Justice and Public Safety Cabinet

Annual Asset Forfeiture Report

Reporting Period – July 1, 2015 through June 30, 2016

KRS 218A.440 requires all law enforcement agencies submit this report within 60 days after the close of the fiscal year.

Specifically, the report should contain assets seized and assets awarded to include cash, vehicles, weapons, and real property.

Complete and submit a report for your agency even if there were no forfeitures during the year.

The forms can be mailed to:

Office of Drug Control Policy - Justice and Public Safety Cabinet – 125 Holmes Street - Frankfort, Kentucky 40601

OR

Faxed to: 502-564-6104

Law Enforcement Agency: xx______Agency Type: ______

Contact Person: xx______title: ______

Mailing Address: ______Telephone: ______

______Fax: ______

______E-Mail: ______

This agency had no forfeitures during this reporting period.

Cash Seized / Cash Awarded / # Vehicles Seized / # Vehicles Awarded / Vehicle Award
$ Amount / # Guns Seized / # Guns Awarded / Gun Award $ Amount / # Real Property Seized / # Real Property Awarded / Real Property Award
$ Amount
$xx / $ / $ / $ / $
$ / $ / $ / $ / $
$ / $ / $ / $ / $
$ / $ / $ / $ / $
$ / $ / $ / $ / $
$ / $ / $ / $ / $
$ / $ / $ / $ / $
$ / $ / $ / $ / $
$ / $ / $ / $ / $
Total columns or continue to next page
$ / $ / $ / $ / $

Agency Head: ______title: ______

Signature:______Date: ______

Attach additional sheets as needed revised 05/1/08


kentucky justice and public safety cabinet

annual asset forfeiture report – continuation page

Cash Seized / Cash Awarded / # Vehicles Seized / # Vehicles Awarded / Vehicle Award
$ Amount / # Guns Seized / # Guns Awarded / Gun Award
$ Amount / # Real Property Seized / # Real Property Awarded / Real Property Award
$ Amount
$ / $ / $ / $ / $
$ / $ / $ / $ / $
$ / $ / $ / $ / $
$ / $ / $ / $ / $
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$ / $ / $ / $ / $
$ / $ / $ / $ / $
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$ / $ / $ / $ / $
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TOTAL
$ / TOTAL
$ / TOTAL
# / TOTAL
# / TOTAL
$ / TOTAL
# / TOTAL
# / TOTAL
$ / TOTAL
# / TOTAL
# / TOTAL
$

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