Forfeiture Victim Questionnaire 

updated 7/14/2006

Please read these instructions before filling out this form. 
Victims with pending cases should contact their lawyers before filling out this form. We will not disseminate the information you submit on this form unless you give us permission, in the last panel of this form. If you want publicity, we can help with that too. 
The purpose of this form is to gather information for a database we hope to build so that we can track trends and compile statistics on forfeiture cases, forfeiture cops and prosecutors and abuses.   In the meantime, we read and reply to each response. 
Don't be overwhelmed by the length of this form -- only some of the questions will apply to your case.  It's okay to leave things blank if they don't apply or you don't know the answer.  But it's very important that  your answers be accurate.  Please get out your forfeiture papers and have them in front of you when you fill out this questionnaire.

Forfeiture Victim		
Victim's name: -enter text here-	Spouse's name: -enter text here-	
Address: -enter text here-	Apt#: -enter text here-	
City: -enter text here-	State: -enter text here-	
Country: enter text here	Zip/Postal Code: -enter text here-	
Phone: -enter text here-	Fax: -enter fax number here-	
Email address: : -enter text here-	Website URL: -enter url here-	
Victim's Attorney		
Attorney's name: -enter text here-	Law Firm: -enter text here-	
Address:  -enter text here-	Suite/Apt#: -enter text here-	
City: -enter text here-	State: -enter text here-	
Country: -enter text here-	Zip/Postal Code: -enter zip code here-	
Phone: -enter text here- 	Fax: -enter fax number here-	
Email address: -enter text here-	Website URL: -enter text here-	
Case data		
What is the name of your forfeiture case, as it appears in the caption on the court documents? If you have more than one forfeiture case, fill out this form separately for each case. (If you have not yet received any court documents, put "N/A" in the field to the right.)	-enter text here-	
Is this case state or federal?
 -enter text here-	What state? -enter text here-	
Name of the court: -enter text here-	Case number -enter text here-	
Location of court -- City: -enter text here-	State: -enter text here-	
What stage of the process are you at now?
Place an “x” next to your answer.
	 __ 1)  property seized, but no process yet 
 __ 2)  administrative process, no court proceedings                       yet 
 __ 3)  case pending in court 
 __ 4)  case closed	
Timeline: To help us study how long the forfeiture process takes, please take the time to insert the exact dates that the key events in your case occurred. Use the six-digit date format DD/MM/YR (for example 01/19/98). If any of the events have not occurred or were skipped in the process you encountered, leave it blank. 	Property seized: -enter date here-
Administrative forfeiture notice received: 
                                                     -enter date here-
Filed claim and posted cost bond: -enter date here- 
Forfeiture complaint filed in court: -enter date here-
Forfeiture trial ended: -enter date here-
Appeal filed: -enter date here-
Appeal decided: -enter date here- 
Case settled: -enter date here-
Case closed -enter date here- 	
Please place an “x” beside the type(s) of offenses the government is alleging in the forfeiture case	   __ drugs 
   __ immigration 
   __ customs violations 
   __ mail/wire fraud 
   __ other fraud 
   __ cash transaction reporting violations 
   __ banking violations 
   __ prostitution 
   __ driving w/o license or DWI 
   __ environmental                              
   __ other (specify)  -enter text here-	
Please list the forfeiture statutes that are charged in your forfeiture complaint. 	      -enter text here-	
Property seized		
Types of property seized – place an “x” next to each type of property seized in your case	   __ my residence 
   __ my business property 
   __ other real estate 
   __ my business itself 
   __ my bank account(s) 
   __ my car 
   __ cash 
   __ other	
If you checked "other" in the field above, list the other property that was seized from you.	     -enter text here-	
How much was the seized property worth all together? Please use fair market value in computing the total. 
Place an “x” next to the appropriate value.	   __ $1000 or less 
   __ $1001 - $5000 
   __ $5,000 - $10,000 
   __ $10,001- $20,000 
   __ $20,001 - $50,000 
   __ $50,001 - $100,000 
   __ $100,001 - $200,000 
   __ $200,001 - $500,000 
   __ $500,001 - $1 million 
   __ more than $1 million	
Did the police have a warrant?
Place an “x” next to your answer.	   __ search warrant                      __ seizure warrant 
   __ no warrant                            __ I don't know	
Were you evicted from your real estate prior to trial?	   __ yes                          __ no                 __ not applicable 
   __ I had to sign an occupancy agreement 	
Administrative Forfeiture Process		
Federal forfeiture procedure and some states' procedures require you to go through an "administrative forfeiture" process that is handled inside the police agency that seized your property -- before you can go to court. The federal administrative forfeiture process starts with an administrative forfeiture notice, which is sent out by regular mail. You have a specified time from receipt to file a claim with the agency and post a cost bond (no longer required for federal seizures), or else you lose the right to go to court. There are other administrative procedures that you can pursue in the agency -- such as filing a "petition for remission or mitigation," asking the agency to give back the property. We want to hear about your experience with the administrative forfeiture process. Please place an “x” next to each applicable answer.	   __ I posted a cost bond. 
   __ I filed "in forma pauperis" asking for waiver of bond because I am indigent. 
   __ I filed a petition for remission instead of posting the cost bond. 
   __ I lost at the administrative level because I didn't post the cost bond in time. 
   __ I didn't get notice of any administrative forfeiture proceedings -- my property was seized, and nothing else happened. 
   __ The process began judicially -- I didn't have to go through the administrative process. 
   __ I lost my case in the administrative process. 	
Which agenc(ies) handled the administrative proceedings in your case?
Place an “x” next to each agency that handled the administrative proceedings in your case.	   __ D.E.A. 
   __ F.B.I. 
   __ INS 
   __ Customs Service 
   __ Other federal agency (specify) 
   __ State agency (specify here) 	
The Judicial Forfeiture Process		
Who represented you in your forfeiture case? 
Place an “x” next to each answer that applies. 	   __ I had to represent myself because I couldn't afford an attorney. 
   __ My court appointed attorney in my criminal case handled my forfeiture case. 
   __ My court-appointed attorney refused to help me. 
   __ I hired an attorney in my criminal case, but he/she didn't handle my forfeiture case. 
   __ I hired an attorney who handled my forfeiture case. 
   __ I hired an attorney but ran out of money before the case was over.	
What happened during discovery? 
Place an “x” next to each answer that applies.	   __ They served interrogatories and requests for production of documents on me. 
   __ They took my deposition. 
   __ I refused to answer some discovery on Fifth Amendment grounds because of a pending criminal case or investigation. 
   __ The court dismissed my claim for refusing to answer the discovery. 
   __ The court entered other sanctions against me for refusing to answer the discovery. 
     Describe sanctions: -enter text here-	
What motions were filed in your case? 
Place an “x” next to each answer that applies.	   __ The government filed a motion to dismiss my claim for lack of standing. 
   __ I filed a motion to suppress evidence. 
   __ I filed a motion to dismiss for undue delay. 
   __ The government filed a motion for summary judgment. 
   __ I filed a motion for summary judgment. 
   __ I filed a proportionality motion. 	
For each of the motions you checked above, state who won.	     --enter motion(s) filed in your case and results here-	
If your case did not go to trial, check the box that best describes what happened. If your case is still pending or it went to trial, skip this section.	   __ The court dismissed my claim for lateness or other filing defect. 
   __ The court dismissed my claim for lack of standing. 
   __ The court dismissed my claim for noncompliance with discovery. 
   __ The court granted summary judgment for the government. 
   __ The court granted summary judgment in my favor. 
   __ The case settled before trial. 
   __ I gave up and abandoned my case before trial. 
   __ The government gave me back my property with no strings attached. 	
If your case went to trial, place an “x” next to the statements that describe what happened. 	   __ The case was tried before a jury 
   __ The case was tried before a judge by agreement of the parties 
   __ The case was tried before a judge because I failed to demand a jury trial in my answer 
   __ The case was tried before a judge because the court ruled there is no right to jury trials in my type of case 
   __ The court allowed the government to introduce   hearsay at trial. 
   __ I won at trial. 
   __ The government won at trial. 
   __ It was a partial victory for each side.	
If you need more room to describe the outcome at trial, do it here.	     --enter text here-	
If there was an appeal, place and “x’ next to the statement that describe what happened. 	   __ The verdict was affirmed. 
   __ The verdict was overturned and the case was retried. 
   __ The verdict was overturned and judgment was entered for the government. 
   __ The verdict was overturned and judgment was entered in my favor. 
   __It was a partial victory for each side.	
If you need more room to describe the outcome on appeal and/or retrial, do it here.	     -enter text here-	
How much did you spend on attorneys fees in your forfeiture case? If your forfeiture case is still pending, how much have you paid so far? 
Place an “x” next to the appropriate answer.	   __ $1000 or less 
   __ $1001 - $5000 
   __ $5,000 - $10,000 
   __ $10,001 - $20,000 
   __ $20,001 - $50,000 
   __ more than $50,000	
If you settled the case, how much "legalized extortion" did you have to pay the government? 
Place an “x” next to the appropriate answer.	   __ $1000 or less 
   __ $1001 - $5000 
   __ $5,000 - $10,000 
   __ $10,001 - $20,000 
   __ $20,001 - $50,000 
   __ more than $50,000	
If you "had it all to do over again," what would you have done differently? 	      -enter text here-	
The Players		
Who was your judge?  If there was more than one, list them all. Please use their full names.	     -enter text here-	
Who was your forfeiture prosecutor?  If there was more than one, list them all. Please use their full names.	     -enter text here-	
What government agencies participated in the seizure? List all the agencies involved.	     -enter text here-	
Use this space to describe any misconduct, corruption, or unfairness you encountered in "the system."	     -enter text here-	
If you encountered any government agents or prosecutors you considered to be corrupt or dishonest, list their full names here and briefly explain.	     -enter text here- 	
Were you charged criminally for the offense that triggered the forfeiture?	     __ yes                         __ no	
Were you convicted of the offense that triggered the forfeiture?	     __ yes                          __ no
     __ not applicable 
     __ the criminal case is still pending 	
Was any co-owner of the property convicted of the offense that triggered the forfeiture?	     __ yes                             __ no	
Was someone else, other than a co-owner of the property, charged with the offense?	     __ yes                               __ no	
Was the other person convicted?	     __ yes                               __ no	
Were there any innocent owners who owned an interest in the property?	     __ yes                               __ no	
Briefly state the innocent owner's story, if applicable.	     -enter text here-	
If you want to tell your story in more detail, do it here.  If your case is pending, check with your lawyer before answering this question.	     -enter text here-	
Do you feel that your case is outrageous, or otherwise merits media attention?	   __ yes                                __ no	
Use this extra space to explain any other aspect of your case that you consider outrageous or unfair.	     -enter text here-	
Did you raise any novel defenses or legal arguments in your case that you would like to share with us?	     -enter text here-	
Are you willing to talk to the news media about your case? Talk this over with your attorney first!	   __ yes                                __ no 
   __Let me think about it - contact me if the media is interested, and I'll decide then.	
Contact person for media: -enter text here-	Contact's phone: -enter text here-	
Are you interested in having your case mentioned on the "FEAR List" or on the FEAR website? Note: There is no guarantee that FEAR will use your story on the list or the website. We may contact you for more information if we choose your victim story for posting.	   __ yes 
   __ no 
   __ Let me think about it	
Today's date: -enter date here-	This form filled out by: -enter text here-	
Are you ready to get involved? Do you want someone from FEAR contact you?	   __ yes                               __ no 
   __ Let me think about it	
Once you have completed this form and checked it over for accuracy, save this document and attach it to an email addressed to: judyosburn@gmail.com
Or print this form and mail it to:
Forfeiture Endangers American Rights
20 Sunnyside Suite A-419
Mill Valley, CA 94941
The information you have entered will be placed in our database, and your name and other identifying information will not be disseminated outside the administrative personnel of our organization unless you give us permission.