Free State of Minnesota - Minnesota

State of Minnesota County Select County

District Court Judicial District: Court File Number: Case Type:

Civil

Demand for Judicial Determination of Forfeiture of Property

(Name) (Address) (City/State) (Telephone) (Zip Code)

vs.

Plaintiff/Claimant Complaint:

(property seized)

Defendant

The plaintiff/claimant in this matter asks for a judicial decision on the forfeiture of the defendant property pursuant to Minn. Stat. §609.5314, subd. 3, claiming the property was improperly seized for the following reasons: (Specify why you are making this claim and your interest in the property seized.) (Use additional sheet(s) if necessary) 1.

2.

3.

Dated:
Signature (Sign only in front of notary public or court administrator.)

Name: Sworn/affirmed before me this day of , . Address: City/State/Zip: Telephone:
Notary Public \ Deputy Court Administrator

FOR402

State

ENG

Rev 2/00

www.courts.state.mn.us/forms

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