California > Federal > USDC Northern > Criminal
Affidavit Of Owner Of Cash Security - California
| Affidavit Of Owner Of Cash Security Form. This is a California form and can be used in Criminal USDC Northern Federal . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
UNITED STATES DISTRICT COURT NO RTHE RN DISTR ICT OF CA LIFO RN IA AFFIDAVIT OF OW NER OF CA SH SECU RITY United States. v. Ca se Number CR By my signature below on the date listed therein, I, the owner of the cash or cash equivalents listed below, hereby certify under penalty of perjury that: 1. The below amount of cash or cash equivalents appearing next to my signature and deposited as security on the foregoing bond is owned by me and is to be returned to me at the below address upon exoneration of this bond, 2. The SSN/TIN/ITIN/EIN shown below is my correct taxpayer identification number, 3. I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 4. I am a U.S. Citizen or other U.S. person as defined as (a) an individual who is a U.S. citizen or U.S. resident alien or (b) a partnership, corporation, company, or association created or organized in the United States or under the law of the United States. Nam e of Owner of Cash Address of Owner of Cash SSN/TIN/ ITIN/EIN* Telephone Number Amount of Cash Signature of Owner Date Signed *NOTE: Upon exoneration, disbursement cannot be made without SSN,TIN, ITIN or EIN. Revised 2-23-2012 American LegalNet, Inc. www.FormsWorkFlow.com
|
|||||||
Popular Searches
