Fillable REPORT ON BLOCKED PROPERTY - TANGIBLE/REAL/OTHER NON-FINANCIAL PROPERTY* (Department of the Treasury - OCIO)

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REPORT ON BLOCKED PROPERTY - TANGIBLE/REAL/OTHER NON-FINANCIAL PROPERTY* (Department of the Treasury - OCIO)

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OMB No. 1505-0164
TD-F 93.08
REPORT ON BLOCKED PROPERTY - TANGIBLE/REAL/OTHER NON-FINANCIAL PROPERTY*
(Use of this form is optional, but the information requested is required by 31 C.F.R. § 501.603)
UNITED STATES DEPARTMENT OF THE TREASURY
OFFICE OF FOREIGN ASSETS CONTROL
REPORTING INSTITUTION INFORMATION
INSTITUTION NAME
ADDRESS
CITY
STATE
POSTAL CODE
COUNTRY
CONTACT PERSON NAME
TITLE
TELEPHONE NUMBER
E-MAIL ADDRESS
DATE PREPARED
PROPERTY INFORMATION
VALUE (USD)
DATE OF BLOCKING
LEGAL AUTHORITY OR AUTHORITIES FOR
BLOCKING (e.g., 31 C.F.R. Part 560)
SANCTIONS TARGET / NEXUS (e.g., name of
Specially Designated National or blocked person)
DESCRIPTION OF PROPERTY
NUMBER AND TYPE OF BLOCKED
PROPERTY (e.g., 2 airplanes, 1 Internet Protocol
address, 3 vehicles, 1 house, 10 diamonds)
ADDRESS OF BLOCKED PROPERTY (i.e.,
physical location where blocked property is held)
PROPERTY MANAGER (OR OTHER
RELEVANT CONTACT) NAME, ADDRESS,
PHONE AND E-MAIL
* Complete all applicable fields and include all other relevant information in the “Additional Relevant Information” field on page 2.
To report blocked financial transactions or accounts, please use the form “Report on Blocked Property – Financial” (Form TD-F
93.02).
PLEASE INCLUDE A COPY OF ANY RELEVANT DOCUMENTATION (E.G., BILL OF LADING, TITLE
DOCUMENTS, PROOF OF BLOCKING) AS A SEPARATE ATTACHMENT
ADDITIONAL RELEVANT INFORMATION
Public reporting burden for this collection of information is estimated to average 30 minutes per response. An agency may not conduct or sponsor, and a
person is not required to respond to, a collection of information unless it displays a valid OMB control number. Send comments regarding this burden
estimate or any other aspect of this collection of information to the Office of Foreign Assets Control, U.S. Department of the Treasury, 1500
Pennsylvania Avenue, N.W., Freedman’s Bank Building, Washington, DC 20220.
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REPORT ON BLOCKED PROPERTY - TANGIBLEREALOTHER NON-FINANCIAL PROPERTY* (Department of the Treasury - OCIO)

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Completed 10 August 2020

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