Professional Documents
Culture Documents
PPD ES Certification 2013
PPD ES Certification 2013
PPD ES Certification 2013
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Equitable Sharing
Agreement and
C e r t i fi c a t i o n
City: Philadelphia
S t a t e : PA
Last: Wallace
PhonefmH
Zip;19106
E-mail:
Last Wallace
^'contact Phone
E-mail:
E-mail:
Last FY
Last
FY
End
End
Date:
Date:
06/30/2013
06/30/2013 Agency Current FY Budget: $571,657,128.00
O N w Partkipanb Read the qultabJe Sharing Agreement and sign the Affidavit
O Existing Participant: Annual
Certification Report, read the Equftable Sharing Agreement, and sign
the Affidavit.
Amended Form:
Revise the Annual Certification Report, read the Equitable Sharing Agreement, arid sign
the Affidavit
Treasury Funds
S1309.499JJ1
$123317.38
$1282.00
Non-Interest Bearing Q
Interest Bearing 0
S2.236.84
$1,854.78
$9,336,697.64
$1,434.67137
$3,623,393.83
$0.00
$5,713,303.81
$1434.67L57
Justice Agencies are: FBI. DEA, ATF, USPlS, USDA. DCIS. DSS, and FDA.
Treasury Agencies are: IRS, ICE, CBP, TTB, USSS, and USCG.
Page 1 of 10
October 2012
j
k
5518.486.40
$22,953.43
$3,070,000.00
Sn,9S4M
To t a J
$3,623393.83
so.oo
Did your agency receive non-cash assets? QYei 0 No If yes, complete Table H.
Agency
Name
NCIC/ORl/TrackIng
Number
Transferring Agency Name, City, and State Justice Funds Treasury Funds
Agency Name:
NCIC/ORI/Tracking Number
R e c e i v i n g A g e n c y N a m e , C l t y a n d S t a t e J u s t i c e F u n d s Tr e a s u r y F u n d s
Agency Name:
NCIC/ORI/Tracking Number
Page 2 of 10
October 2012
VfntcwZI
Description of Expense
Justice Funds
Recipient
Description of Asset
Justicc O
Treasury Q
Table I: Civil Rights Cases
Name of Case
Race
r~, NaUonal
Color
Gender
JosetteTussey
Dfeabifity Age
Race
Jermaine Bullock
Usability Age
Race
C o l "
Kevin Hand
Disability Age
Race
Origin DC*"*'
p. National r-lraArlar
Tamara Breeden
Page 3 of 10
October 2012
Version 2.1
Name of Case
Race
Steven Bennett
Disability
Race
Erica Mclntyre
Disability
Gender
Race
RamkumarGanesan
Disability
NsUonal
Race
Disability
Race
Disability
Race
Regina Swan
Thomas Ford
Rachelle Guzy
National
Origin
National
Origin
Q Gender
Q Gender
Q Gender
Disability Age
i?ace
Origin
Gender
Color
Pouria Shokouhl
Disability Age
Race
Color
Charles Widman
Disability Age
Page4of 10
National
Origin
Gender
October 2012
Vnl9n3J
OominlcTardborelli
Race Color
Dlsabflfty Q Age
S "
Other Ovit Rights
Race Cotor
Olsabilily QAge
Q Race Q Color
ST'
Disability Age
1I NatJonal
n,tin Gender
Other Racial Proftlfn
origin
s r '
other Civil Rights
o f r
Other Civil Wghts
Race Color
ooKr'
Disability Age
Race Color
Disability Age
Race Color
Miguel Alers (and Szustowia)
Disability Age
oiir'
Q Race Color
Orlando DeStefano
ST*
Race Q Color
glKsablKty QAge
Race Color
Disability QAge
Q Race Q Color
RexRosiji
ST*
gjDIsabliity QAge
Race Color
Disability QAge
g] Race Color
Disability QAge
Race Color
ST'
Disability Age
^ Race Color
S" <^0-
Disability Age
Color
n!?^'
Gender
Origin ^
Race Cofor
p.
National Gender
^ Ongin
Q Disability
other
Race Color
|- National Gender
^Origin
Disability QAge
Other Discrimination
Q Race Color
Kenneth Rosstter
Disability Age
Race C<rfor
CXher Discriminatton
National
Origin
m Gender
Disability Age
^ other Discrimination
Q Race Color
ST*
Disability Age
Other Discrimination
O Race Color
p. National
Disability Age
other
Origin
m Gender
Race Color
udrey Carter-Smith
Disability Age
other
(3 Race Color
Nat
ional ii
Origin
Disability ^Age
Other
Race P Color
ST*
Disability Age
(pother Discrimination
Carmo Dixon-ftolllns
Race Color
Disability Age
Q Other
13 Race Color
jess Pierce Seynfiour
Disability QAge
other
Race Color
^Disability Age
Race Color
Disability Age
Page 7 of 10
October 2012
Antoinette Trapp
^ Race Color
PI
National Gender
^ Oii^n
Disability QAge
other
Race Color
pn
National Gender
^ Origin
Disability QAge
Other
National
Race Color
Cendei
Disability QAge
other
Race Color
Disability QAge
^ Other Discrlminaton
Race Color
Disability Age
^ other Discrimination
gl Race Color
DlsablH^ Age
Other
Race
Jasniine Young
Origin
Color
Disability Age
I t
I I
I t
Pq
L-J Nati
Origoinnal
Gender
Gender
Gender
s Gender
other
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,
1400 New York Avenue, N,W., Washington, DC 20005.
Page 8 of 10
0ctober2012
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