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. ยง609.5314, 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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