DRAFT SHARING AGREEMENT AND CERTIFICATION.PDF

OMB Number 1123-0011
Expires9-30-2014
Equitable Sharing
Agreement and
Certification
o Police Department @ Sheriff's Office 0 Task Force (Complete Table A) ~~
O Prosecutor's Office 0 National Guard Counterdrug Unit 0 Other 1f\_-__ ~_~
Q~r
• Please fill each required field. Hover mouse over any fillable field for pop-up instructions. •
Agency Name: Maricopa County Sheriffs Office
NCIC/ORIITracking Number: I A I z I 0 I 0 I 7 I 0 I 0 I 0 I 0 I
Mailing Address: 100W. Washington St., Suite 1900
City: Phoenix State: Zip: 85003
AZ-----
Finance Contact: First: Chief Scott Last: Freeman
------------------------
Phone: 602-876-5497 E-mail: S_Freeman@MCSO.maricopa.gov
-------_
Preparer: First: Nivin Last: Kateeb
---------------------
Sameas
D Finance Contact Phone: 602-876-3245 E-mail: N Kateeb@MCSO.maricopa.gov
Independent Public Accountant: E-mail:
-----------------------
Last FY End Date: 06/30/2013 Agency Current FY Budget: $298,336,365.00
o
New Participant: Readthe Equitable Sharing Agreement and sign the Affidavit.
Complete the Annual Certification Report, readthe Equitable Sharing Agreement, and sign
@ Existing Participant:
the Affidavit.
o Amended Form: Revisethe Annual Certification Report, read the Equitable Sharing Agreement, and sign
the Affidavit.
Annual Certification Report
Summary of Equitable Sharing Activity Justice Funds1 Treasury Funds 2
Beginning Equitable Sharing Fund Balance(must match
1
Ending Equitable Sharing Fund Balancefrom prior FY) $105,692.88
2 FederalSharing Funds Received
FederalSharing Funds Receivedfrom Other Law Enforcement
3
Agencies and TaskForces(To populate, complete Table B) $5,188.94
4 Other Income
Non-Interest Bearing0
5 Interest Income Accrued
Interest Bearing @ $504.09
6 Total Equitable Sharing Funds (total of lines 1- 5)
$106,196.97 $5,188.94
7 FederalSharing Funds Spent (total of lines a - m below)
$0.00 $5,188.94
8 Ending Balance(difference between line 7 and line 6)
$106,196.97 $0.00
1 Justice Agencies are: FBI, DEA, ATF, USPIS, USDA, DClS, DSS, and FDA.
2 Treasury Agencies are: IRS, ICE, CBP, TIB, USSS,and USCG.
Page1of 5 October 2012
Version 2.1

Summary of Shared Funds Spent Justice Funds Treasury Funds
a Total spent on salaries under permitted salary exceptions
b Total spent on overtime $5,188.94
c Total spent on informants, "buy money", and rewards
d Total spent on travel and training
e Total spent on communications and computers
f Total spent on weapons and protective gear
g Total spent on electronic surveillance equipment
h Total spent on buildings and improvements
Total transfers to other participating state and local law
i
enforcement agencies (To populate, complete Table C)
Total spent on other law enforcement expenses(To populate,
j
complete Table D)
Total Expenditures in Support of Community-Based Programs
k
(To populate, complete Table E)
I Total Windfall Transfers(To populate, complete Table F)
Total spent on matching grants (To populate, complete
m
Table G)
n Total $0.00 $5,188.94
0 Did your agency receive non-cash assets?0 Yes @No If yes,complete Table H.
Pleasefill out the following tables, if applicable.
Table A: Members of Task Force
Agency Name NCIC/ORIITracking Number
I I I I I I I I I I
Table B: Equitable Sharing Funds Received from other Agencies
Transferring Agency Name, City, and State Justice Funds Treasury Funds
Agency Name: IU.S.Immigration and Customs Enforcement, Phoenix, AZ
NCIC/ORlfTrackingNumber: I A I Z I I I C I E I 0 I 0 I 0 I 0 I
Table C: Equitable Sharing Funds Transferred to Other Agencies
Receiving Agency Name, City, and State Justice Funds Treasury Funds
Agency Name:I
1==
NCIC/ORlfTrackingNumber: I
I I I I I I I I I
Paqe z of S October 2012
Version 2.1

Table D: Other Law Enforcement Expenses
Description of Expense Justice Funds Treasury Funds
II III II
Table E: Expenditures in Support of Community-Based Programs
Recipient Justice Funds
Table F: Windfall Transfers
Recipient Justice Funds Treasury Funds
II
Table G: Matching Grants
Matching Grant Name Justice Funds Treasury Funds
II
Table H: Other Non-Cash Assets Received
Source Description of Asset
Justice0
I II
Treasury0
Table I: Civil Rights Cases
Name of Case Type of Discrimination Alleged
DRace o Color o O. National . lOG en d er
ngm
o Disability o Age o Other
Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information
unless it displays a valid OMB control number. We try to create accurate and easily understood forms
that impose the least possible burden on you to complete. The estimated average time to complete this
form is 30 minutes. If you have comments regarding the accuracy of this estimate, or suggestions for
making this form simpler, please write to the Asset Forfeiture and Money Laundering Section,
1400New York Avenue, N.W., Washington, DC 20005.
Page3 of 5 October 2012
Version 2.1

Equitable Sharing Agreement
This FederalEquitable Sharing Agreement, entered into among (1)the FederalGovernment, (2)the above-stated law
enforcement agency ("Agency"),and (3)the governing body, setsforth the requirements for participation in the
federal Equitable Sharing Program and the restrictions upon the useof federally forfeited cash,property, proceeds,
and any interest earned thereon, which are equitably sharedwith participating law enforcement agencies.
Byits signatures,the Agency agreesthat it will be bound by the statutes and guidelines that regulate sharedassets
and the following requirements for participation in the federal Equitable Sharing Program. Receiptof the signed
Equitable SharingAgreement and Certification (this "Document") isa prerequisite to receiving any equitably shared
cash,property, or proceeds.
1.Submission. This Document must be submitted to aca.submit@usdoj.govwithin 60 daysof the end of the
Agency'sfiscal year. This Document must be submitted electronically with the Affidavit/Signature submitted by fax.
Thiswill constitute submission to the Department of Justiceand the Department of the Treasury.
2. Signatories. This agreement must be signed by the head of the Agency and the head of the governing body.
Examplesof Agency headsinclude police chief, sheriff, director, commissioner, superintendent, administrator,
chairperson, secretary,city attorney, county attorney, district attorney, prosecuting attorney, state attorney,
commonwealth attorney, and attorney general. The governing body's head isthe person who allocatesfunds or
approves the budget for the Agency. Examplesof governing body headsinclude city manager, mayor, city council
chairperson, county executive, county council chairperson, director, secretary,administrator, commissioner, and
governor.
3. Uses. Any sharedassetshall be usedfor law enforcement purposes in accordancewith the statutes and guidelines
that govern the federal Equitable Sharing Program asset forth in the current edition of the Department of Justice's
Guide to Equitable Sharing for State and Local Law Enforcement (Justice Guide), and the Department of the Treasury's
Guide to Equitable Sharing for Foreign Countries and Federal, State, and Local Law Enforcement Agencies (Treasury
Guide).
4. Transfers. Beforethe Agency transfers cash,property, or proceedsto other state or local law enforcement
agencies,it must first verify with the Department of Justiceor the Department of the Treasury,depending on the
sourceof the funds, that the receiving agency isa current and compliant Equitable Sharing Program participant.
5. Internal Controls. The Agency agreesto account separatelyfor federal equitable sharing funds received from the
Department of Justiceand the Department of the Treasury. Fundsfrom state and local forfeitures and other sources
must not be commingled with federal equitable sharing funds. The Agency shall establish a separaterevenue
account or accounting code for state, local, Department of Justice,and Department of the Treasuryforfeiture funds.
Interest income generated must be accounted for in the appropriate federal equitable sharing account.
The Agency agreesthat such accounting will be subject to the standard accounting requirements and practices
employed for other public funds assupplemented by requirements set forth in the current edition of the Justice Guide
and the Treasury Guide, including the requirement in the Justice Guide to maintain relevant documents and recordsfor
five years.
The misuseor misapplication of shared resourcesor the supplantation of existing resourceswith sharedassetsis
prohibited. Failureto comply with any provision of this agreement shall subject the recipient agency to the sanctions
stipulated in the current edition of the Justice or Treasury Guides, depending on the sourceof the funds/property.
6. Audit Report. Audits will be conducted asprovided by the Single Audit Act Amendments of 1996and OMB
CircularA-133. The Department of Justice and Department of the Treasuryreservethe right to conduct periodic
random audits.
Page4of5 October 2012
Version 2.1

Affidavit - Existing Participant
d t...
<; a I r '11en
I l
Before you can p"int this form, you must correct the following
d mrnatio en nrm dg- ny p on 01
errors: ig ta ed e: or as t cy
Enter the e-mail address for the Independent Public Accountant
a 1;;l aqe hE" nc -una inst r
on Rage · v der qh ')
You must answer the Civil Rights question in the blue box on 5.
f. r .0 t " , <: Ie
You must enter the name of the Agency Head on page 5.
You must enter the title of the Agency Head on page 5.
You must enter the e-mail address of the Agency Head on page 5.
You must enter the name of the Governing Body Head on page 5.
You must enter the title of the Governing Body Head on page 5.
You must enter the e-mail address of "the Governing Body Head
on page 5.
Subscribe to Equitable Sharing Wire:
The Equitable Sharing Wire is an electronic newsletter that )=================1
gives you important, substantive, information regarding
Equitable Sharing policies, practices, and procedures.
Final Instructions:
Step 1: Click to save for your records Step 3: E-mail the XML file to aca.submit@usdoj.gov
Step 2: Click to save in XML format Step 4: Fax THISSIGNED PAGEONLY to (202) 616-1344
FORAGENCYUSEONLY
Entered by _
Entered on _ III"
1 111111111111111111" 1111111111111
o FYEnd: 06/30/2013 Date Printed: August 13,2013 13:35
® NCIC: AZ0070000 Agency: Maricopa County Sheriffs Office Phone: 602-876-5497
o
State: AZ Finance Contact: Chief Scott Freeman E-mail: S_Freeman@MCSO.maricopa.gov
Page5 of 5 October 2012
Version 2.1
-----