Statement of Special Moneys and
Property Transaction
/ 1. Division / 2. Post of Duty / 3. Control Number4. Name / 5. Title / 6. Date
7. Receipts / 8. Disposals (Check One):
Transfer Refund Deposit / Closing Status (Check One):
Forfeiture Returned
Description
7(a) / Date
7(b) / Name & Case Number
7(c) / Amount
7(d) / Date
8(a) / Name & Case Number
8(b) / Amount
8(c) / To Whom
8(d)
Recovered moneys held as evidence / 0.00 / 0.00
Moneys held for safekeeping / 0.00 / 0.00
Bribe Moneys
/ 0.00 / 0.00Seized Property:
/ 0.000.00
0.00
0.00
0.00
0.00 / 0.00
0.00
0.00
0.00
0.00
0.00
TOTAL
9. Location /Amount
/ 10. I certify that the above is a full, true, and a correct statement of allmoneys received or disposed of on this date.
Cash in Office Safe
/ $ / Signature:In Safety Deposit Box
/ $ / Title:Bureau of Public Debt
/ $ / Date:Other (describe): / $
TIGTA Form OI 141 – Statement of Special Moneys and Property Transaction (Rev. 01/2005) Treasury Inspector General for Tax Administration
INSTRUCTIONS FOR PREPARING FORM OI 141
1. Prepare a separate Form OI 141 for each case. If there is more than one seizure on the same date for a single case, note each seizure amount separately on the same Form OI 141. If there is more than one seizure on different dates for a single case, note each seizure on a separate Form OI 141.
2. Enter the division, post of duty, name, and title of the responsible agent in items 1, 2, 4, and 5, respectively.
3. Enter the date the Form OI 141 is prepared in item 6.
4. In reporting receipts, record the seizure date in item 7(b), the name and case number in item 7(c), and the amount of the monies or fair market value for each property item listed in item 7(a) or in an attachment, in item 7(d).
5. Enter the location of the monies or property in item 9.
6. In reporting disposals for all monies and property, check the appropriate box for FORFEITED or RETURNED in item 8, enter the date of the final disposition in item 8(a), the name and case number in item 8(b), and the amount of monies or fair market value for each property item listed in 7(a) or in an attachment, in item 8(c). For moneys or seized property RETURNED to the defendant, relative, non-profit organization, etc., obtain a signed receipt witnessed by at least two agents and forward the original receipt and one copy with the Form OI 141 to the Divisional Seized Assets PPM Program Coordinator. For monies FORFEITED to the federal government, forward a money order or cashier’s check made payable to TIGTA, attach the completed Form OI 141 and record in item 8(d) that the money order or cashier’s check is to be sent to BPD for deposit into the Federal Reserve Bank. In all instances, the amounts reported in 8(c) must be the same as the amounts initially reported in item 7(d) under receipts. Appreciation or depreciation of property is not to be considered.
7. Special Agent is to enter his/her signature, title and date signed in item 10. Electronic signatures are acceptable.
8. Special Agents are to prepare an original and three copies and distribute as follows:
(a) Special Agent retains one copy for his/her file and sends the original and two copies to the Divisional Seized Assets PPM Program Coordinator.
(b) Divisional Seized Assets PPM Program Coordinator forwards the original and one copy and any other pertinent documentation to the Nationwide Seized Assets PPM Program Coordinator and retains a copy of the Form OI 141 and all documentation in the divisional files.
(c) The Nationwide Seized Assets PPM Program Coordinator inserts a control number in item 3 on the original Form OI 141 and enters the required information in the PPM database. Each case is assigned one control number. On any subsequent Forms OI 141 relating to the same case, the Divisional Seized Assets PPM Program Coordinator should enter the assigned control number in item 3.
DEFINITIONS
Forfeited: Ownership of the seized monies or seized property is transferred from the original owner to another entity. For example, seized monies given to the IRS for taxes owed or given to the Federal Reserve Bank for deposit into miscellaneous receipts or seized property is destroyed, given to a non-profit organization or maintained by TIGTA in its undercover equipment inventory, etc.
Returned: Ownership of the seized monies or seized property is returned to the original owner. For example, the seized monies or seized property is returned to the defendant, to the spouse, a relative, etc.
TIGTA Form OI 141 – Statement of Special Moneys and Property Transaction (Rev. 01/2005) Treasury Inspector General for Tax Administration