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BRENDA GRANTLAND Cal. Bar #165899
Attorney for Claimant
265 Miller Avenue
Mill Valley, CA 94941
415-380-9108

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

UNITED STATES OF AMERICA      	:
                              				:	Case No. C 02-0000 ABC
           Plaintiff,         				:	
                              				:	
       v.                     				:	
                              				:	
$123,456 IN UNITED STATES 		:	VERIFIED STATEMENT OF INTEREST
CURRENCY					:
						:
	Defendant.				:
                                                                        : 	

	Claimant, John Doe, through undersigned counsel, files this verified Statement of Interest in the property described above.  As grounds for this claim claimant states the following:
	1.  I am the owner of the currency seized in the above-entitled action.  I  hereby claim the right to defend this action.
VERIFICATION
	I, John Doe, verify that I have read  the foregoing Claim, and declare under penalty of perjury that the allegations therein are true and correct.
Executed on this ____ day of __________________, 2000.

							       ________________________
								JOHN DOE, Claimant

			                                   Respectfully submitted,

                                     			________________________
                                       			BRENDA GRANTLAND, ESQ.
						
CERTIFICATE OF SERVICE
	I hereby certify that a copy of the foregoing verified claim was served, by mail, upon Assistant United States Attorney Robert Ward, 450 Golden Gate Avenue, Box 36055, San Francisco, CA 94102, this ________  day of ___________________, 2003.

				                               		_________________________
								Brenda Grantland