CID-013 (11/2018)

Michigan State Police

PROSECUTOR'S AUTHORITY TO DISPOSE OF PROPERTYSeizing Law Enforcement Agency Phone Number

- Location to File Claim Address

Address Where Seized: Number and Street City State Zip Code

Description of Property - Describe Fully

(Manufacturer/Make/Serial No. - Denomination/Amount of Money)

PROOF OF SERVICE

I served a copy of the Notice of Seizure and Intention to Forfeit and Dispose of Property as follows:

Person Served Date Served How Notice Served Certified Mail

In Person Publication

Address: Number and Street City State Zip Code

Signature of Server Date Signed Reviewed By

DISTRIBUTION:

Original - Owner or Interested Parties

Claim Deadline Date Seized

Incident No. AUTHORITY: MCL 333.7523 COMPLIANCE: Required PENALTY: Return of property to owner

Value of PropertyProperty

Number

PROSECUTOR'S AUTHORITY TO DISPOSE OF PROPERTY

Authorization is granted to dispose of the above seized items with the following exceptions:

Signature of Prosecutor Date Signed Signature Not Required:

No Criminal Charges Pending

RECORD OF SEIZURE