State of Minnesota County: ___________________________ Judicial District: Court File Number: Case Type: District Court Civil Petition for Return of Seized Property Minn. Stat. §626.04 (Name) (Address) (City/State) (Zip Code) (Agency Acting as Custodian of the Seized Property) vs. (Address) (City/State) Plaintiff/Claimant ) ) SS ) (Zip Code) Defendant STATE OF MINNESOTA COUNTY OF Plaintiff/Claimant says: 1. I own property that was seized by a law enforcement officer for use as evidence in a trial. 2. The property was seized in the following county: ____________________________________. 3. I want all or some of this property returned to me. The property I want returned is: (Describe each item of property. Attach additional sheets if more space is needed.) 4. I made a written request for return of the property to the seizing officer's agency before filing this petition. (Attach a copy of your written request.) 5. At least 48 hours have passed, not including weekends and legal holidays, since the agency received my written request. The property has not been returned to me. Page 1 of 2 FOR502 State ENG Rev 7/15 www.mncourts.gov/forms American LegalNet, Inc. www.FormsWorkFlow.com Order Requested: I ask that the Court order defendant to return my property to me. I understand that if the Court denies my request to return the property, the Court may order me to pay the defendant reasonable costs and attorney fees. I declare under penalty of perjury that everything I have stated in this document is true and correct. Minn. Stat. § 358.116. Dated: Signature Name: Address: City/State/Zip: Telephone: ( ) E-mail address: ____________________________ FOR502 State ENG Rev 7/15 www.mncourts.gov/forms Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com