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FEDERAL RESERVE BANK
OF NEW YORK
F isca l A g en t o f the U nited States

Circular No. 10435 ~
1
February 13, 1991

[
CENSUS OF BLOCKED IRAQI ASSETS
AND U.S. CLAIMS AGAINST IRAQ
Reports to be Filed by March 1

To All Banks, and Others Concerned,
in the Second Federal Reserve District:

The Department of the Treasury has issued the following statement in connection with the re­
porting of claims against the Government of Iraq.
Holders of blocked Iraqi property and U.S. nationals wishing to assert claims against the Govern­
ment of Iraq will be required to report to the Treasury Department’s Office of Foreign Assets Control
under regulations published in the F ederal R egister.
Reports on claims against the Government of Iraq must be submitted by March 1, 1991. The sub­
mission of a claims report will not constitute the formal filing of a claim for compensation against the
Government of Iraq.
Reports by holders of blocked Iraqi property must be submitted by March 1, 1991, or within 15
days of the acquisition of the property, whichever is later. This information is needed by the U.S. Gov­
ernment to monitor compliance with the asset freeze imposed by President Bush following Iraq’s invasion
of Kuwait on August 2, 1990.
Copies of the necessary report forms were published in yesterday’s F ederal R egister, or can be ob­
tained by contacting one of the twelve regional Federal Reserve Banks located throughout the country
or by calling the Office of Foreign Assets Control at (202) 535-4026. Photocopies of the report forms
may be used.
The Treasury’s official notice in this matter has been published in the Federal Register of Feb­
ruary 11, 1991 (56 FR 5636). Also published in that Federal Register are the necessary report forms
and instructions to be used by U.S. nationals and holders of blocked Iraqi property in making claims
against the Government o f Iraq . Copies o f those forms or the complete Federal Register notice can
be obtained from the Circulars Division (Tel. 212-720-5215 or 5216), or can be picked up in the
Issues Division area on the first floor of this Bank (33 Liberty Street).
Questions regarding this matter should be directed to the Blocked Assets Division of the Office
of Foreign Assets Control, Department of the Treasury (Tel. No. 202-535-4026) or, at this Bank,
to Bradley K. Sabel, Counsel (Tel. No. 212-720-5041).




E. G e r a l d C o r r i g a n ,

President.

TDF 90-22.40

OMB Number 1505-0128
Expiration D»le-01/31/92

CENSUS OF BLOCKED IRAQI PROPERTY
INSTRUCTIONS FOR REPORTING ON FORM TDF 90-22.40
The Office of Foreign Assets Control, Department of the Treasury, under Section 575.604
of the Iraqi Sanctions Regulations (31 CFR Part 575) ("the Regulations"), is conducting a
census of blocked Iraqi property. The information is needed by the United States Government
for planning purposes and to monitor compliance with the Regulations.

GENERAL INSTRUCTIONS
Reporting on Form TDF 90-22.40, Report of Blocked Iraqi Property, is mandatory for all
persons who, since August 2, 1990, have held property subject to Executive Order Nos. 12722
or 12724.
This requirement applies to all U.S. persons who had in their possession or
control, since 5:00 a.m., EDT, August 2, 1990 ("the effective date"), any property or
interests in property belonging to the Government of Iraq, its agencies, instrumentalities
and controlled entities and the Central Bank of Iraq. Reports filed on Form TDF 90-22.40 are
regarded as privileged and confidential.
Two copies of the report shall be sent to the Office of Foreign Assets Control,
Department of the Treasury, Washington, D.C. 20220, by March 1, 1991, or within 15 days of
the acquisition of property subject to Executive Order Nos. 12722 or 12724.
The reporter
shall retain a copy of the completed report. Copies of Form TDF 90.22-40 will be distributed
through the Federal Reserve System to all regional Federal Reserve Banks.
In addition,
copies of the form will be mailed directly to certain persons believed by the Treasury
Department to be affected by the reporting requirements. Other persons required to report
or interested in obtaining copies of the form may do so by contacting the Office of Foreign
Assets Control at the above address or by calling the telephone number listed below.
Photocopies of the report form may be used.
A report may be filed on behalf of a holder by an attorney, agent, or other person.
Primary responsibility for reporting blocked property, however, rests with the actual holder
of the property, or the U.S. national exercising control over property located outside the
U.S., with the following exceptions: primary responsibility for reporting any asset held by
a foreign firm or branch owned or controlled by a U.S. person rests with the U.S. parent or
head office; primary responsibility for reporting any trust assets rests with the trustee;
and primary responsibility for reporting real property rests with the Iraqi owner's co-owner,
legal representative, agent, or property manager in the United States. No person is excused
from filing Form TDF 90-22.40 by reason of the fact that another person has submitted a
report with regard to the same property, unless he has actual knowledge that the other person
has filed a report with respect to the property as full and complete as that which he would
otherwise be required to file.
A separate report shall be submitted with respect to each blocked account or asset
held. Each question on the form shall be answered and all the specific information called
for shall be given. When there is nothing to report under any question, or if information
is lacking, state "N/A," "None," or "Unknown," as the case may be. If the space provided on
the form is inadequate, the answer may be made or continued on a blank sheet of paper
securely attached to the form. No person is excused from furnishing information he
reasonably should have furnished. The definitions of terms contained in the Regulations are
hereby incorporated by reference into Form TDF 90-22.40 and these instructions.
FOR FURTHER INFORMATION CALL:

(202) 535-4026.

SPECIFIC INSTRUCTIONS
PART A: IRAQI GOVERNMENT ENTITY HAVING AN INTEREST IN THE PROPERTY REPORTED
Lines 1-3.
State the name and address of the Iraqi Government entity which has an interest
in the property reported. If any other entities or persons, whether Iraqi or non-Iraqi, have
interests in the property reported, the full value of the property shall be reported in Part
B, Line 4, Columns (a) and (b), but the names and pro rata interests of all such entities or
persons shall be identified in Line 3 of Part A.




i

PART B

PROPERTY REPORTED

Line 4.
Provide a brief description of the property reported.
If the property is
denominated in a foreign currency, report the U.S. dollar equivalent value on the dates
indicated and state the currency and conversion rate in the description. The following table
may be used as a guide for items to include in the property description:
Property

Items to include in description.

Deposit

Account number, type o f account, and interest rate terms (including, i f applicable, index to w hich rate is pegged).

Securities o r Bullion

Account number and b rie f description o f securities or bullion.

Documentary Letter o f Credit

Account party, other principal parties involved (including the issuing, confirm ing, and advising banks), and whether o r not documents have been
presented.

Standby Letter o f Credit

Account party, all principal parties involved (including issuing and confirm ing banks), expiration date, and whether o r not any calls have been made.

Section 575.518 Account

Number and date o f Treasury license permitting establishment o f account.

Credits or Other Obligations

Type o f obligation (including a description o f the transaction giving rise to the obligation).

Real Property

Location and description o f the property.

Tangible Property

B rie f description o f the property.

IF PROPERTY REPORTED WAS HELD ON THE EFFECTIVE DATE: Report value of the property held
on August 2, 1990 in Column (a) and value of the property held on January 31, 1991 in
Column (b).
IF PROPERTY REPORTED WAS ACQUIRED AFTER THE EFFECTIVE DATE: Fill in date the property
was acquired on the line indicated and report value of the property held on that date
in Column (a) and value of the property on January 31, 1991 in Column (b). If the
property was acquired after January 31, 1991, disregard Column (b).
Line 5.
If the property reported was acquired after August 2, 1990, describe the
circumstances.
Include the name of the transferor or prior holder and the reasons the
property was transferred.
Line 6. Explain any changes between amounts in Columns (a) and (b) of Line 4. Include the
number, total amounts, and nature of all increases and credits (e.g., interest credited,
deposits, incoming transfers) and decreases (e.g., service charges, licensed debits). If any
Treasury Department licenses have been issued with respect to the account, indicate the
number and date of the license.
This question may be disregarded if the property was
acquired after January 31, 1991.
Line 7. If the property reported is physically located or booked at a location other than
that described in Part C (e.g., a deposit located in a foreign branch reported by the U.S.
parent) give the name and the location of the actual holder.
Line 8. Describe any claims known to be asserted against the property reported. Examples
include specific claims such as attachments and liens or more general claims such as set-off
rights asserted by the holder of the property against the Government of Iraq. Indicate the
full amount of the claim and the identity of the claimant.

PART C:

U.S. PERSON OR ENTITY MAKING THE REPORT

Lines 9-11. State reporter’s corporate name and address and the name and telephone number
of an individual corporate official to contact regarding the report.
Line 12.

>

Complete the certification.

The report is not valid without the certification.

The estimated burden associated with this collection of information is 2 hours per
respondent or recordkecper. Comments concerning the accuracy of this burden
estimate and suggestions for reducing this burden should be directed to the Blocked
Assets Section, Office of Foreign Assets Control, Department of the Treasury,
Washington, D .C . 20220 and die Office of Management and Budget, Paperwork
Reduction Project (1505-0128), Washington, D .C . 20503.

PAPERWORK REDUCTION ACT STATEMENT: The paperwork requirement has
been cleared under the Paperwork Reduction Act of 1980. The Office of Foreign
Assets Control o f the Department o f the Treasury requires this information be
furnished pursuant to SO U .S.C . 1701, and 31 CFR Part S75. The information
collected will be used for U .S. Government planning purposes and to monitor
compliance with Executive Order Nos. 12722 and 12724. The information will be
held confidential.




ii

TDF 90-22.40

OMB Number 1505-0128
Expiration Date-01/31/92

REPORT OF BLOCKED IRAQI PROPERTY
Office of Foreign Assets Control
Department of the Treasury
Washington, D.C. 20220
This report shall be completed and two copies sent to the above address by all U.S.
persons who, since August 2, 1990, have held property subject to Executive Order Nos. 12722
or 12724. Reports shall be submitted by March 1, 1991, or within 15 days of acquiring such
property. Separate reports should be submitted for each blocked account or asset held. READ
THE INSTRUCTIONS CAREFULLY BEFORE PREPARING THIS REPORT. For assistance call (202) 535-4026.

TO THE SECRETARY OF THE TREASURY:
The undersigned, pursuant to 31 CFR 575.604, hereby makes the following report:

PART A: IRAQI GOVERNMENT ENTITY HAVING AN INTEREST IN THE PROPERTY REPORTED
1. Entity:
2. Address:

3. Identify any other entities or persons known to have interests in the property reported
and explain the nature and extent of such interests:

PART B: PROPERTY REPORTED
(a)
Value On
08/02/90

4. Description of the Property.

<b)

Value On
01/31/91

(Include account number and interest terms, if applicable.)
(Specify Acquisition Date, If Later)

(Amount)

(Amount)

5. If custody of the property was acquired after August 2, 1990, describe the circumstances.
Include name of transferor or prior holder and reasons the property was transferred.




Page 1

TDF 90-22.40

REPORT OF BLOCKED IRAQI PROPERTY

6. Explanation of any changes between amounts in Columns (a) and (b) above. Include the
number and nature of all transactions, the total amount of all increases and/or
decreases, and the number and date of any related Treasury Department licenses.

7. Name of the holder and location of the property if different than described in Part C.

Describe any claims known to be asserted against the property.

PART C:

U.S. PERSON OR ENTITY MAKING THE REPORT

9. Name:
10. Address:

11. Individual to contact
regarding this report:
(Name)

(Telephone Number)

12. Certification:

I,

, certify that I am the
(Corporate Title or Position, If Applicable)

(Name)

that I am authorized to make this certification,

of the
(Corporate Name, I f Applicable)

and that, to the best of my knowledge and belief, the statements set forth in this report,
including any papers attached hereto or filed herewith, are true and accurate, and that all
material facts in connection with said report have been set forth herein.




(Signature)

(Date)

OMB Number 1505-0129

TDF 90-22.41

Expiration Date-01/31/92

CENSUS OF CLAIMS BY U.S. NATIONALS AGAINST IRAQ
INSTRUCTIONS FOR REPORTING ON FORM TDF 90-22.41
The Office of Foreign Assets Control, Department of the Treasury, under Section 575.605
of the Iraqi Sanctions Regulations (31 CFR Part 575) ("the Regulations"), is conducting a
census of claims by U.S. nationals against the Government of Iraq, or any Iraqi Government
entity.
The information is needed by the U.S. Government for planning purposes.
Note:
The submission of this report does not constitute the filing with the U.S.
Government of a formal claim for compensation.
No formal claims adjudication program
currently exists.
However, failure to file complete information in a timely fashion would
not only constitute failure to comply with the Regulations but would also prevent the
inclusion of the information in U.S. Government planning and therefore could be prejudicial
to the interests of the claimant and other U.S. claimants.
Espousal of claims of U.S.
nationals against a foreign government is within the discretion of the U.S. Government.

GENERAL INSTRUCTIONS
Reporting on Form TDF 90-22.41 is mandatory for all U.S. nationals (whether individuals
or legal entities) who, on 5:00 p.m., EST, January 16, 1991, had claims outstanding against
the Government of Iraq, or any Iraqi Government entity. The report may also include claims
of U.S. nationals arising from ownership in foreign entities. The report shall be completed
and two copies sent to the Office of Foreign Assets Control, Department of the Treasury,
Washington D.C. 20220, by March 1, 1991. The reporter shall retain a copy of the completed
report. Reports filed on Form TDF 90-22.41 are regarded as privileged and confidential.
Copies of Form TDF 90.22-41 will be distributed through the Federal Reserve System to
all regional Federal Reserve Banks. In addition, copies of the form will be mailed directly
to certain persons believed by the Treasury Department to be affected by the reporting
requirements. Other persons required to report or interested in obtaining copies of the form
may do so by contacting the Office of Foreign Assets Control at the above address or by
calling the telephone number listed below. This pamphlet contains reporting instructions,
one copy of report Form TDF 90-22.41, and three copies of Schedule Bl. Photocopies of the
report form and schedule may be used.
A report may be filed on behalf of a claimant by an attorney, agent, or other person.
Primary responsibility for reporting the claim, however, rests with the actual claimant.
Each question on the form shall be answered and all the specific information called for shall
be given. When there is nothing to report under any question, or if information is lacking,
state "N/A," "None," or "Unknown," as the case may be. If the space provided on the form is
inadequate, the answer may be made or continued on a blank sheet of paper securely attached
to the form. The definitions of terms contained in the Regulations are hereby incorporated
by reference into Form TDF 90-22.41 and these instructions.
FOR FURTHER INFORMATION CALL:
(202) 535-4026.

SPECIFIC INSTRUCTIONS
PART A: INFORMATION CONCERNING U.S. CLAIMANT
Lines 1-2. State the name, employer identification or social security number, and address
of the U.S. claimant. If the report includes claims for losses suffered by a subsidiary, the
name, employer identification number, and address of the U.S. parent company reporting the
claim should be entered here.
Line 3. State the nationality or place of incorporation of the claimant. If there has been
any change in the nationality status of the claimant since the date of loss, provide an
explanation.
Line 4. If the claimant is a corporation or other legal entity, indicate the date and place
of incorporation, the percentage of outstanding capital stock of all classes held, directly
or indirectly, by persons who were U.S. nationals on the date of the loss.
Line 5. If the person reporting the claim is a person other than the claimant as reported
in Line 1, state name, address, and relationship to the claimant (e.g., attorney, personal
representative).




P A R T B:

S U M M A R Y OF C L A I M S A G A I N S T IRAQ

Line 6.
Report the aggregate value of all claims of a common type in the appropriate
category or categories shown.
Detailed information concerning specific claims should be
reported on one or more attached Schedule Bl's. The sum of all amounts reported separately
on Schedule B1 should total the aggregate amount reported in the summary.

PART C: CERTIFICATION
Line 7.
Enter the name
regarding the report.
Line 8.
Complete
certification.

the

and telephone number of the

certification.

The

report

appropriate

is

not

valid

individual to contact

without

a

completed

INSTRUCTIONS FOR
SCHEDULE B1 - SCHEDULE FOR SEPARATE DESCRIPTION OF CLAIMS
Note:
Be sure to enter the employer identification number or social security number
of the U.S. claimant from Part A, Line 1, in the space indicated in upper right hand corner
of the schedule. Also enter the number of this individual Schedule B1 and the total number
of Schedule Bl's submitted in the spaces indicated.
Submit an individual Schedule B1 for each claim or common set of claims.
individual person or a single entity (e.g., a subsidiary) against the same
involving a common set of circumstances may be reported on a single Schedule Bl,
allocated appropriately to each category of claim. Three copies of Schedule Bl
to the report. Additional photocopies of Schedule Bl may be used, if needed.

Claims of an
Iraqi entity
with amounts
are attached

Lines 1-2.
Enter the name and address of the entity actually suffering the loss, if
different from the claimant named in Part A, Line 1 (e.g., a claim arising from injury to a
subsidiary).
Line 3. If the entity described in Line 1 of this Schedule Bl is different than the claimant
named in Part A, Line 1, include a full description of the claimant's ownership interest in
the entity.
Line 4.

Identify the Iraqi entity against which the claim is asserted.

Line 5. Enter the value of each claim in the appropriate category. Report the claim in U.S.
dollars to the nearest dollar.
Convert foreign currency values at the exchange rate
prevailing on the date of the loss.
In valuing the claims, use estimated values as of the
date of the loss if precise values or balances are not known.
Be sure to describe your
valuation methods in Line 6.
Line 6.
Describe the circumstances of the loss.
Include the date of the loss and a
description of the property, business, obligation, injury, or other damage which is the
subject of the claim.
Identify any other persons with interests in the claim and an>
alternative sources of compensation available, actual or potential.
Describe any knowr
counterclaims that potentially may be asserted by the Government of Iraq.
If the clain
involves a contract dispute, describe any clauses in the contract referring to choice of lav
or forum for settling disputes. If the property is of the type for which a specific balance
or generally accepted market quotation value is not available, indicate the valuation methoc
used (e.g., contractual value, book value, estimated value of similar property).
If the
property or obligation is valued in a foreign currency, be sure to specify the currency anc
the exchange rate used in the valuation. Do not submit documentary evidence with the report

PAPERWORK REDUCTION ACT STATEMENT: The paperwork requirement has
been cleared under the Paperwork Reduction Act of 1980. The Office o f Foreign
Assets Control o f the Department o f the Treasury requires this information be
furnished pursuant to 50 U .S .C . 1701, and 31 CFR Part 575. The information
collected will be uacd for U .S. Government planning purposes. The information will
be held confidential.




The estimated burden associated with this collection o f information is 3.5 hours p<
respondent or recordkeeper. Comments concerning the accuracy o f this burde
estimate and suggestions for reducing this burden should be directed to the Blocks
Assets Section, Office o f Foreign Assets Control, Department o f the Treasur
Washington, D .C . 20220 and the Office o f Management and Budget, Paperwoi
Reduction Project (1505-0128), Washington. D .C . 20503

ii

OMB Number 1505-0129
Expiration Date-01/31/92

TDF 90-22.41

R E P O R T OF C L A I M S B Y U.S.

NATIONALS AGAINST IRAQ

Office of Foreign Assets Control
Department of the Treasury
Washington, D.C.
20220
This form shall be completed and two copies sent to the above address by March 1, 1991,
by all U.S. nationals who, on 5:00 p.m., EST, January 16, 1991, had claims outstanding
against the Government of Iraq, or any Iraqi Government entity.
A third copy shall be
retained by the reporter. READ THE INSTRUCTIONS CAREFULLY BEFORE PREPARING THIS REPORT. For
assistance call (202) 535-4026.
IMPORTANT: The submission of this report does not constitute the filing with the U.S.
Government of a formal claim for compensation, nor does it guarantee that the claim will be
included in any future agreement or settlement.
However, failure to file complete
information in a timely fashion would not only constitute failure to comply with Section
575.605 of the Iraqi Sanctions Regulations (31 CFR Part 575) but would also prevent the
inclusion of the information in U.S. Government planning and therefore could be prejudicial
to the interests of the claimant and other U.S. claimants.

TO THE SECRETARY OF THE TREASURY:
The undersigned, pursuant to 31 CFR 575.605, hereby makes the following report:

PART A:

INFORMATION CONCERNING U.S. CLAIMANT

1. Name:____________________________________________________

EIN/SSN:___________________'

2. Address:

3. State nationality or place of incorporation. If there has been any change in nationality
status since the date of the loss, so explain.

4. If claimant is a corporation or other legal entity, state date and place of incorporation,
percentage of outstanding capital stock of all classes held, directly or indirectly, by
U.S. nationals on the date of the loss.

5. If the person reporting the claim is a person other than the claimant named in Line 1,
state name, address, and relationship to claimant.




Psee 1

P A R T B:

S U M M A R Y OF C L A I M S A G A I N S T IRAQ

6. Claims
Report the aggregate value of all claims in the appropriate category or categories
below.
Detailed information concerning specific claims should be reported on one or more
attached Schedule B l ’s.
The sum of all amounts reported on Schedule B1 should total the
aggregate amount reported in this summary. Three copies of Schedule B1 are attached to this
pamphlet.
Additional photocopies may be used, if required.
A. Business Claims
(1) Loans or credits overdue or in default

____________________

(2) Expropriation of equity, concessions, or going concern v a l u e ____________________
(3) Expropriation of real and/or tangible property

____________________

(4) Receivables or other amounts due and unpaid

____________________

(5) Breach of contract damages

____________________

(6) Other damages

__________________
Subtotal A.

B. Personal Claims
(1) Expropriation losses
(2) Salaries, benefits, or other items due and unpaid
(3) Lost future benefits or other contractual claims
(4) Personal injury or other tort claims
(5) Other damages
Subtotal B.
TOTAL (Subtotals A. + B.)

PART C: CERTIFICATION
7. Individual to contact
regarding this report: ______________________________________
(Nunc)

_______________
(Telephone Number)

8. Certification:
I,

, certify that I am t h e ___________________________________
(Name)

(Corporate Title or Position, If Applicable)

of the ___________________________________ , that I am authorized to make this certification,
(Coiporate Name, If Applicable)

and that, to the best of my knowledge and belief, the statements set forth in this report,
including any papers attached hereto or filed herewith, are true and accurate, and that all
material facts in connection with said report have been set forth herein.




(Signature)

(Date)

Page 2

TDF 90-22.41 (Schedule B l)

EIN or SSN of Claimant:__________________________ .
This i s _______ o f _________ Schedule Bis submitted.
(Number)

(Total Number)

SCHEDULE Bl - SCHEDULE FOR SEPARATE DESCRIPTION OF CLAIMS
(See Specific Instructions)
1. Name:
2. Address:

3. Describe the relationship of this entity to the claimant named in Part A.

4. Identify the Iraqi entity against which the claim is asserted.*
1

5. Type and amount of claim reported on this Schedule Bl.
A. Business Claims
(1) Loans or credits overdue or in default
(2) Expropriation of equity, concessions, or going concern value
(3) Expropriation of real and/or tangible property
(4) Receivables or other amounts due and unpaid
(5) Breach of contract damages
(6) Other damages
Subtotal A.
B. Personal Claims




(1) Expropriation losses
(2) Salaries, benefits, or other items due and unpaid
(3) Lost future benefits or other contractual claims
(4) Personal injury or other tort claims
(5) Other damages
SubtotalB.
TOTAL (Subtotals A. + B.)

Page 1

•

I

i

r

TDF

90-22.41

(Schedule

Bl)

1

6. Describe the circumstances of the loss.
Include the date of the loss and a descriptior1
of the property, business, obligation, injury, or other damage which is the subject of the>
claim. Do n o t su b m it docum entary evidence.
(See Specific Instructions)

%

1

i

•

1^




Page

2

TDF 90-22.41 (Schedule B l)

EIN or SSN of Claimant:__________________________ .
This i s _______ o f _________ Schedule Bis submitted.
(Number)

(Total Number)

SCHEDULE Bl - SCHEDULE FOR SEPARATE DESCRIPTION OF CLAIMS
,

(See Specific Instructions)

1. Name:
2. Address:

3. Describe the relationship of this entity to the claimant named in Part A.

4. Identify the Iraqi entity against which the claim is asserted.*
1

5. Type and amount of claim reported on this Schedule Bl.
A. Business Claims
(1) Loans or credits overdue or in default
(2) Expropriation of equity, concessions, or going concern value
(3) Expropriation of real and/or tangible property
(4) Receivables or other amounts due and unpaid
(5) Breach of contract damages
(6) Other damages
Subtotal A.
B. Personal Claims




(1) Expropriation losses
(2) Salaries, benefits, or other items due and unpaid
(3) Lost future benefits or other contractual claims
(4) Personal injury or other tort claims
(5) Other damages
SubtotalB.
TOTAL (Subtotals A. + B.)

Page 1

*

TDF 90-22.41 (Schedule B l)

6. Describe the circumstances of the loss.
Include the date of the loss and a description
of the property, business, obligation, injury, or other damage which is the subject of the
claim.
Do not submit documentary evidence.
(See Specific Instructions)




Page 2

TDF 90-22.41 (Schedule B l)

EIN or SSN of Claimant:__________________________ .
This i s _______ o f _________ Schedule Bis submitted.
(Number)

(Total Number)

SCHEDULE Bl - SCHEDULE FOR SEPARATE DESCRIPTION OF CLAIMS
(See Specific Instructions)
1. Name:

________________________________________________________________________

2. Address:

3. Describe the relationship of this entity to the claimant named in Part A.

4. Identify the Iraqi entity against which the claim is asserted.*
1

5. Type and amount of claim reported on this Schedule Bl.
A. Business Claims
(1) Loans or credits overdue or in default
(2) Expropriation of equity, concessions, or going concern value
(3) Expropriation of real and/or tangible property
(4) Receivables or other amounts due and unpaid
(5) Breach of contract damages
(6) Other damages
Subtotal A.
B. Personal Claims




(1) Expropriation losses
(2) Salaries, benefits, or other items due and unpaid
(3) Lost future benefits or other contractual claims
(4) Personal injury or other tort claims
(5) Other damages
SubtotalB.
TOTAL (Subtotals A. + B .)

Page 1

TDF 90-22.41 (Schedule B l)

6. Describe the circumstances of the loss.
Include the date of the loss and a description
of the property, business, obligation, injury, or other damage which is the subject of the
claim.
Do not submit documentary evidence.
(See Specific Instructions)




Page 2

Monday
February t1 , 1991

Part XIV

Department of the
Treasury
O ffice o f Foreign Assets Control
31 CFR Part 575
Iraqi Sanctions Regulations; Census of
Blocked Iraqi Governm ent Assets and
Claims Against Iraq and Iraqi
Governm ent Entities; Final Rule

(Ref. Cir no.




10435)

5636

Federal Register / VoL 5 , No. 28 / Monday, February 11, 1991 / Rules and Regulations
6

DEPARTMENT OF THE TREASURY
31 CFR Part 575
Iraqi Sanctions Regulations; Census of
Slocked Iraqi Government Assets and
Claims Against Iraq and Iraqi
Government Entities
agency:

Office of Foreign Assets

Control.
a c t io n :

Final rule.

SUMMARY: The Office of Foreign Assets
Control is amending the Iraqi Sanctions
Regulations by the addition of
§ § 575.604 and 575.605, providing,
respectively, for a census of blocked
assets of the Government of Iraq and a
census of claims against the
Government of Iraq. The amendments
impose a requirement that reports,
contained in the appendix to this rule,
be filed (1) under 5 575.604 with respect
to blocked Iraqi assets held by any U.S.
person on or after August 2 ,19S0, and (2)
under § 575.605 with respect to claims
held by U.S. nationals against the
Government of Iraq as of 5 p.m., E.S.T.,
' January 16,1991. The amendments also
add a definition of “United States
national" as § 575.322 for use in
determining who must report on claims
pursuant to § 575.604, and make other
technical corrections.
EFFECTIVE DATE: February 11.1991.

FOR FURTHER INFORMATION CONTACT:

Loren L Dohm, Chief, Blocked Assets
Section, Office of Foreign Assets
Control, Department of the Treasury,
Washington, DC 20220, (202) 535-4026.
SUPPLEMENTARY INFORMATION: The Iraqi
Sanctions Regulations, 31 CFR part 575
56 FR 2112, January 18,1991 ("the
Regulations”), were issued by the
Treasury Department in implementation
of Executive Order 12722 of August 2,
1990 (55 FR 3183, August 3,1990) and
Executive Order 12724 of August 9,1990
(55 FR 33089, August 13,1990), and
United Nations Security Council
(“UNSC”) Resolution 661 (August 6,
1990) and subsequent relevant
resolutions. In the appendix to these
amendments, the Office of Foreign
Assets Control has provided samples of
forms TDF 90-22.40 and TDF 90-22.41,
with instructions to be used in reporting
information on blocked assets and
claims. The reports are needed to obtain
information, on a one-time basis,
regarding blocked Iraqi assets and
claims by U.S. nationals against the
Government of Iraq, for planning and
administrative purposes. This census
responds, in part, to UNSC Resolution
674 (October 29,1990), which invites UN
member states to collect information on




claims against the Government of Iraq.
Additional reports may be required at a
future date. Persons required to report or
otherwise interested in obtaining copies
of the forms and instructions may do so
by contacting the nearest regional
Federal Reserve Bank or the Office of
Foreign Assets Control, Department of
the Treasury, Washington, DC 20220.
The reports required to be filed by
these sections must be completed in
triplicate and two copies are to be
returned in a set to the Office of Foreign
Assets Control, Department of the
Treasury, Washington, DC 20220, by
March 1,1991. Observance of the filing
deadline is extremely important.
Reporting under these sections is
mandatory. However, information
regarding property of private Iraqi
citizens is not subject to the reporting
requirement of section 575.604.
The submission of a TDF 90-22.41
report on a claim against the
Government of Iraq does not constitute
the filing with the United States
Government of a formal claim for
compensation. No formal claims
adjudication program currently exists.
However, failure to file a complete
report with respect to claims in a timely
fashion not only would constitute failure
to comply with the Regulations, but
would also prevent the inclusion of the
information in U.S. Government
planning and may therefore be
prejudicial to the interests of the
claimant and other U.S. claimants.
Espousal of claims of U.S. nationals
against a foreign government is within
the discretion of the United States
Government. Information regarding
claims of the United States Government
against the Government of Iraq will be
collected separately.
The Supplementary Information
section of the original publication of the
Regulations (58 FR 2112, January 18,
1991} requires certain modifications, as
follows: First, in the table in the second
paragraph the reference to General
License No. 3, as amended, should
indicate that this general license is
revoked in the Regulations. Second, the
fifth paragraph should indicate that the
collections of information in the
Regulations are contained in
5§ 575.202(d), 575.503, 575.506, 575.509575.511, 575.517, 575.518, 575.520, 575.521,
subpart F, § 575.703, and § 575.801.
Third, the sixth paragraph should
indicate that the estimated total annual
reporting and/or recordkeeping burden
(including the burden imposed by this
amendment) is 10,000 hours.
Since the Regulations involve a
foreign affairs function, the provisions of
the Administrative Procedure Act, 5
U.S.C. 553, requiring notice of proposed

rulemaking, opportunity for public
participation, and delay in effective
date, are inapplicable. Because no
notice of proposed rulemaking is
required for this rale, the Regulatory
Flexibility A ct 5 U.S.C. 601 e t seq., dees
not apply. Because the Regulations are
issued with respect to a foreign affairs
function of the United States, they are
not subject to Executive Order 12291 of
February 17,1981, dealing with Federal
regulations.
List of Subjects in 31 CFR Part 575
Blocking of assets, Foreign claims,
Iraq, Reporting and recordkeeping
requirements.
PART 575— IRAQI SANCTIONS
REGULATIONS

For the reasons set forth in the
preamble, 31 CFR part 575 is amended
as set forth below:
1. The "authority” citation for part 575
continues to read as follows:
Authority: 50 U.S.C. 1701 e t se q .; 50 U.S.C.
1601 e t se q .; 22 U.S.C. 287c: Pub. L 101-513,
104 Stat 2047-55 (Nov. 5.1990): 3 U.S.C 301:
E.0.12722. 55 FR 31803 (Aug. 3,1990); E.O.
12724, 55 FR 33089 (Aug. 13,1990).
Subpart C—General Definitions

2. Section 575.322 is added to subpart
C to read as follows:
§ 5752322
national.

United States national; U.S.

The term "United States national” or
"U.S. national” means any United States
citizen; any person who, though not a
citizen of the United States, owes
permanent allegiance to the United
States; and any juridical person
organized under the laws of the United
States or any jurisdiction within the
United States. This term does not
include U.S. branches of persons
organized under foreign law, or aliens,
regardless of whether they have
permanent resident status in the United
States.
Subpart E—Licenses, Authorizations
and Statements of Licensing Policy
§575.503

[Am ended]

3. In § 575.503 of subpart E, paragraph
(i) is removed.
§575.507

[Am ended]

4. Section 575.507(a)(1) of subpart E is
amended to correct two references, as
follows:
“15 CFR 371.6” is corrected to read
"15 CFR 771.6”, and “15 CFR 371.13” is
corrected to read “15 CFR 771.13".

Federal Register / Vol. 50, No. 28 / Monday, February 11, 1991 / Rules and Regulations
Subpart F—Reports

5. Section 575.604 is added to subpart
F to read as follows:
§ 575.604 Reports on Form TDF 90-22.40.

(a) Requirement for report Reports on
Form TDF 90-22.40 are hereby required
to be filed on or before March 1,1991, in
the manner prescribed herein and in the
instructions to Form TDF 90-22.40, with
respect to all property held by any
United States person, in which the
Government of Iraq has or has had any
interest at any time since 5 a.m. E.D.T.,
August 2,1990. Reports must contain
complete answers to every question
included in Form TDF 90-22.40.
(b) Who must report. Reports on Form
TDF 90-22.40 must be filed by each of
the following:
(1) Any U.S. person, or his successor,
who has had in his custody, possession
or control, directly or indirectly, in trust
or otherwise, property in which there
was any direct or indirect interest of the
Government of Iraq at any time since 5
a.m. e.d.t., August 2,1990;
(2) Any business or non-busines3
entity in the United States in which the
Government of Iraq holds or has held
any financial interest since 5 a.m. e.d.t.,
August 2,1990.
(c) H ow to file Form TDF90-22.40.
Reports on Form TDF 90-22.40 shall be
prepared in triplicate. On or before
March 1,1991, two copies shall be sent
in a set to Unit 604, Office of Foreign
Assets Control, Department of the
Treasury, Washington, DC 20220. The
third copy must be retained with the
reporter’s records.
(d) Certification. Every report on Form
TDF 90-22.40 shall contain the
certification required in Part C of the
Form. Failure to complete the
certification shall render the report
ineffective, and the submission of such a
report shall not constitute compliance
with this section.
(e) Confidentiality o f reports. Reports
on Form TDF 90-22.40 are regarded as
privileged and confidential.
6. S e c tio n 575.605 is a d d e d to su b p art
F to r e a d a s fo llo w s:
9 575.605

Reports on Form TDF 90-22.41.

(a)
Requirement for reports. Reports
on Form TDF 90-22.41 are hereby
required to be filed on or before March
1.1991, in the manner prescribed herein
and in the instructions to Form TDF 9022.41, with respect to all claims held by
U.S. nationals as of 5 p.m., e.s.t., January
16.1991, a g a in s t th e G o v e r n m e n t o f Iraq
or a n Iraqi g o v e r n m e n t e n tity . R ep o rts
m u st c o n ta in c o m p le te a n s w e r s to e v e r y
q u e stio n in c lu d e d in Form 90-22.41.




(b) Who m ust report Reports on Form
TDF 90-22.41 must be filed by every U.S.
national who had a claim outstanding at
5 p.m., e.s.t., January 18,1991, against
the Government of Iraq or an Iraqi
government entity. No report is to be
submitted by a U.S. branch of a foreign
firm not owned or controlled by a U.S.
national.
(c) How to-file Form TDF90-22.41.
Reports on Form TDF 90-22.41 shall be
prepared in triplicate. On or before
March 1,1991, two copies shall be sent
in a set to Unit 605, Office of Foreign
Assets Control, Department of the
Treasury, Washington, DC 20220. The
third copy must be retained with the
reporter’s records.
(d) Certification. Every report on Form
TDF 90-22.41 shall contain the
certification required on Part C of the
Form. Failure to complete the
certification shall render the report
ineffective, and the submission of such a
report shall not constitute compliance
with this section.
(e) Confidentiality o f reports. Reports
on Form TDF 90-22.41 are regarded as
privileged and confidential.
(f) Examples o f claims. Claims may
relate to losses due to expropriation,
nationalization, or other measures
affecting property rights; losses for
breach of contract or debt defaults;
compensation for injuries to persons or
loss of life; and any other losses or
injuries suffered in Iraq, Kuwait or
elsewhere, attributable to the
Government of Iraq or an Iraqi
government entity, whether or not
arising from actions relating to Iraq's
invasion of Kuwait Claims may also
relate to losses suffered by a foreign
partnership, joint venture, corporation or
other entity in which U.S. nationals have
a significant interest
Dated: January 31,1991.
R. Richard Newcomb,

Director. .
Approved: February 4,1991.
John P. Simpson,

Acting Assistant Secretary (Enforcement).
Appendix: The forms and instructions
included in this Appendix will not appear in
the CFR.

Census of Blocked Iraqi Property
Instructions for Reporting on Form TDF

90-22.40
The Office of Foreign Assets Control,
Department of the Treasury, under
Section 575.604 of the Iraqi Sanctions
Regulations (31 CFR Part 575) ("the
Regulations"), is conducting a census of
blocked Iraqi property. The information
is needed by the United States
Government for planning purposes and

5637

to monitor compliance with the
Regulations.
General Instructions
Reporting on Form TDF 90-22.40,
Report of Blocked Iraqi Property, is
mandatory for all persons who, since
August 2,1990, have held property
subject to Executive Order No. 12722 or
12724. This requirement applies to all
U.S. persons who had in their
possession or control, since 5:00 a.m.,
EDT, August 2,1930 (“the effective
date”), any property or interests in
property belonging to the Government of
Iraq, its agencies, instrumentalities and
controlled entities and the Central Bank
of Iraq. Reports filed on Form TDF 9022.40 are regarded as privileged and
confidential.
Two copies of the report shall be sent
to the Office of Foreign Assets Control,
Department of the Treasury,
Washington, DC 20220, by March 1,
1991, or within 15 days of the acquisition
of property subject to Executive Order
No. 12722 or 12724. The reporter shall
retain a copy of the completed report.
Copies of Form TDF 90-22.40 will be
distributed through the Federal Reserve
System to all regional Federal Reserve
Banks. In addition, copies of the form
will be mailed directly to certain
persons believed by the Treasury
Department to be affected by the
reporting requirements. Other persons
required to report or interested in
obtaining copies of the form may do so
by contacting the Office of Foreign
Assets Control at the above address or
by calling the telephone number listed
below. Photocopies of the report form
may be used.
A report may be filed on behalf of a
holder by an attorney, agent, or other
person. Primary responsibility for
reporting blocked property, however,
rests with the actual holder of the
property, or the U.S. national exercising
control over property located outside the
U.S., with the following exceptions:
primary responsibility for reporting any
asset held by a foreign firm or branch
owned or controlled by a U.S. person
rests with the U.S. parent or head office;
primary responsibility for reporting any
trust assets rests with the trustee; and
primary responsibility for reporting real
property rests with the Iraqi owner’s co­
owner, legal representative, agent, or
property manager in the United States.
No person is excused from filing Form
TDF 90-22.40 by reason of the fact that
another person has submitted a report
with regard to the same property, unless
he has actual knowledge that the other
person has filed a report with respect to
the property as full and complete as that

5638

Federal Register / Vol. 5 , No. 28 / Monday, February 11, 1991 / Rules and Regulations
6

which he would otherwise be required
to file.
A separate report shall be submitted
with respect to each blocked account or
asset held. Each question on the form
shall be answered and ail the specific
information called for shall be given.
When there is nothing to report under
any question, or if information is
lacking, state “N/A," “Nona,” or
“Unknown,” as the case may be. If the
space provided on the form is
inadequate, the answer may be made or
continued on a blank sheet of paper
securely attached to the form. No person
is excused from furnishing information
Property

he reasonably should have furnished.
The definitions of terms contained in the
Regulations are hereby incorporated by
reference into Form TBF 90-22.40 and
these instructions.
FOR FURTHER INFORMATION CALL: (202]
535-4028.
Specific Instructions
Part A: Iraqi Government Entity Having
an Interest in the Property Reported
Lines 1-3. State the name and address
of the Iraqi Government entity which
has an interest in the property reported.
If any other entities or persons, whether
Iraqi or non-Iraqi, have interests in the

property reported, the hill value of the
property shall be reported in Part B, Line
4, Columns (a) and (b), but the names
and pro rata interests of all such entities
or persons shall be identified in Line 3 of
Part A.
Part B: Property Reported
Line 4. Provide a brief description of
the property reported. If the property is
denominated in a foreign currency,
report the U.S. dollar equivalent value
on the dates indicated and state the
currency and conversion rate in the
description. The following table may be
used as a guide for items to include in
the property description:

Item s to indude in description

D ep o sit...— ___ _________________________ Account number, type of account, and interest rate ta rn s (inducting, if applicable, index to which rate is pegged).
SecuriSee o r Buffion._________________ — . Account number and brief description of securities or bullion.
Docum entary Letter of Crecfit____________ Account party, other principal parties involved (including the issuing, confirm ing, and advising banks), and w hether or not
documents have been presented.
Standby Letter of C red it________________ Account party, all principal parties involved (including issuing and confirm ing banks), expiration date, and w hether or not
any calls have been m ade.
Section 575.518 A ccount_______________ Num ber and date of Treasury license perm itting establishm ent of account
Credits or O ther O bligations.____________ Type of obligation (including a description of the transaction giving rise to the obligation).
R eal P roperty__________________________ Location and description of the property.
Tangible Property_______________________ Brief description of the property.

If property reported was h eld on the
effective date: Report value of the

property held on August 2,1990 in
Column<a) and value of the property
held on January 31,1991 in Column (bj.
If property reported w as acquired
after the effective date : Fill in date the

property was acquired on the line
indicated and report value of the
property held on that date in Column (a)
and value of the property on January 31,
1991 in Column (b). If the property was
acquired after January 31,1991,
disregard Column (b).
Line 5. If the property reported was
acquired after August 2,1990, describe
the circumstances. Include the name of
the transferor or prior holder and the
reasons the property was transferred.
Line A Explain any changes between
amounts in Columns (a) and (b) of Line
4. Include the number, total amounts,
and nature of all increases and credits
(e.g., interest credited, deposits,
incoming transfers) and decreases [e.g.,
service charges, licensed debits). If any
Treasury Department licenses have
been issued with respect to the account,
indicate the number and date of the
license. This question may be
disregarded if the property was acquired
after January 31,1991.
Line 7. If the property reported is
physically located or booked at a
location other than that described in
Part C (e.g., a deposit located in a
foreign branch reported by the U.S.




parent) give the name and the location
of the actual holder.
Line A Describe any claims known to
be asserted against the property
reported. Examples include specific
claims such as attachments and liens or
more general claims such as set-off
rights asserted by the holder of the ,
property against the Government of
Iraq. Indicate the full amount of the
claim and the identity of the claimant.
Part C: U.S. Person or Entity Making the
Report
Lines 9-11. State reporter’s corporate
name and address and the name and
telephone number of an individual
corporate official to contact regarding
the report
Line 12. Complete the certification.
The report is not valid without the
certification.
Paperwork Reduction A ct S tatem en t

The paperwork requirement has been
cleared under the Paperwork Reduction
Act of 1980. The Office of Foreign
Assets Control of the Department of the
Treasury requires this information be
furnished pursuant to 50 U.S.C. 1701,
and 31 CFR Part 575. The information
collected will be used for U.S.
Government planning purposes and to
monitor compliance with Executive
Order Nos. 12722 and 12724. The
information will be held confidential
The estimated burden associated with
this collection of information is 2 hours
per respondent or recordkeeper.

Comments concerning the accuracy of
this burden estimate and suggestions for
reducing this burden should be directed
to the Blocked Assets Section, Office of
Foreign Assets Control Department of
the Treasury, Washington, DC 20220
and the Office of Management and
Budget Paperwork Reduction Project
(1505-0128), Washington, DC 20503.
Report of Blocked Iraqi Property
Office of Foreign Assets Control,
Department of the Treasury,
Washington, DC 20220
This report shall be completed and
two copies sent to the above address by
all U.S. persons who, since August 2,
1990, have held property subject to
Executive Order No. 12722 or 12724.
Reports shall be submitted by March L.
1991. or within 15 days of acquiring such
property. Separate reports should be
submitted for each blocked account or
asset held. READ THE INSTRUCTIONS
CAREFULLY BEFORE PREPARING
THIS REPORT. For assistance call (202)
535-4028.
To the Secretary of the Treasury:
The undersigned pursuant to 31 CFR
575.604, hereby makes the following
report:
Part A: Iraqi Government Entity Having
an Interest in the Property Reported
1. Entity:
2. Address:

Federal Register / Vol. 5 , No. 28 / Monday, February 11, 1991 / Rules and Regulations
0

3.
Identify any other entities or
persons known to have interests in the
property reported and explain the nature
and extent of such interests:

forth in this report including any papers
attached hereto or filed herewith, are true
and accurate, and that all material facts in
connection with said report have been set
forth herein.
(Signature)
(Date)

Part B: Property Reported
4. Description of the Property.
(Include account number and interest terms,
if applicable.)
(a) Value on 08/02/90 or

Census of Claims by U.S. Nationals
Against Iraq
Instructions for Reporting on Form TDF
90-22.41

The Office of Foreign Assets Control,
Department of the Treasury, under
Section 575.605 of the Iraqi Sanctions
Regulations (31 CFR Part 575) ("the
(Amount)
Regulations"), is conducting a census of
(b) Value on 01/31/91
claims by U.S. nationals against the
Government of Iraq, or any Iraqi
(Amount)
Government entity. The information is
5.
If custody of the property was
needed by the U.S. Government for
acquired after August 2,1990, describe
the circumstances. Include name of
planning purposes.
transferor or prior holder and reasons
Note: The submission of this report does
the property was transferred.
not constitute the filing with the U.S.
Government of a formal claim for
compensation. No formal claims adjudication
program currently exists. However, failure to
6.
Explanation of any changes
between amounts in Columns (a) and (b) file complete information in a timely fashion
above. Include the number and nature of would not only constitute failure to comply
with the Regulations but would also prevent
all transactions, the total amount of all
theinclusion of the information in U.S.
increases and/or decreases, and the
Government planning and therefore could be
number and date of any related
prejudicial to the interests of the claimant
Treasury Department licenses.
and other U.S. claimants. Espousal of claims
of U.S. nationals against a foreign
government is within the discretion of the
7.
Name of the holder and location of U.S. Government
the property if different than described
General Instructions
in Part C.
Reporting on Form TDF 90-22.41 is
mandatory for all U.S. nationals
(whether individuals or legal entities)
8.
D e s c r ib e a n y c la im s k n o w n to b e
who, on 5:00 p.m., EST, January 16,1991,
a s s e r te d a g a in s t th e p rop erty.
had claims outstanding against the
Government of Iraq, or any Iraqi
Government entity. The report may also
Part C: U.S. Person or Entity Making the
include claims of U.S. nationals arising
Report
from ownership in foreign entities. The
9. Name:
report shall be completed and two
copies sent to the Office of Foreign
10. A d d r e ss:
Assets Control Department of the
Treasury,Washington D.C. 20220, by
March 1,1991. The reporter shall retain
11.
In d iv id u a l to c o n ta c t regard in g th isa copy of the completed report. Reports
report:
filed on Form TDF 90-22.41 are regarded
as privileged and confidential
(Name)
Copies of Form TDF 90.22-41 will be
distributed through the Federal Reserve
(Telephone Number)
System to all regional Federal Reserve
12. C ertification :
Banks. In addition, copies of the form
I ,_____________________________________________________ ____________
will be mailed directly to certain
(Name)
persons believed by the Treasury
certify that I am the ----------------------Department to be affected by the
(Corporate Title or Position, If Applicable)
reporting requirements. Other persons
of the___________________________
required to report or interested in
(Corporate Name, If Applicable)
obtaining copies of the form may do so
that I am authorized to make this
by contacting the Office of Foreign
certification, and that to the best of my
knowledge and belief, the statements set
Assets Control at the above address or
(Specify acquisition date, if later)




5639

by calling the telephone number listed
below. This pamphlet contains reporting
instructions, one copy of report Form
TDF 90-22.41, and three copies of
Schedule Bl. Photocopies of the report
form and schedule may be used.
A report may be filed on behalf of a
claimant by an attorney, agent, or other
person. Primary responsibility for
reporting the claim, however, rests with
the actual claimant Each question on
the form shall be answered and all the
specific information called for shall be
given. When there is nothing to report
under any question, or if information is
lacking, state "N/A,” “None,” or
"Unknown,” as the case may be. If the
space provided on the form is
inadequate, the answer may be made or
continued on a blank sheet of paper
securely attached to the form. The
definitions of terms contained in the
Regulations are hereby incorporated by
reference into Form TDF 90-22.41 and
these instructions.
FOR FURTHER INFORMATION CALL: (202)
535-4026.
Specific Instructions
Part A: Information Concerning U.S.
Claimant
Lines 1-2. State the name, employer
identification or social security number,
and address of the U.S. claimant If the
report includes claims for losses
suffered by a subsidiary, the name,
employer identification number, and
address of the U.S. parent company
reporting the claim should be entered
here.
Line 3. State the nationality or place
of incorporation of the claimant If there
has been any change in the nationality
status of the claimant since the date of
loss, provide an explanation.
Line 4. If the claimant is a corporation
or other legal entity, indicate the date
and place of incorporation, the
percentage of outstanding capital stock
of all classes held, directly or indirectly,
by persons who were U.S. nationals on
the date of the loss.
Line 5. If the person reporting the
claim is a person other than the
claimant as reported in Line 1, state
name, address, and relationship to the
claimant (e.g., attorney, personal
representative).

Part B: Summary of Claims Against Iraq
Line Q Report the aggregate value of
.
all claims of a common type in the
appropriate category or categories
shown. Detailed information concerning
specific claims should be reported on
one or more attached Schedule Bl's. The
sum of all amounts reported separately

5640

Federal Register / Vol. 5 , No. 28 / Monday, February 11, 1991 / Rules and Regulations
6

o n S c h e d u le B 1 sh o u ld to ta l th e
a g g r e g a te a m o u n t re p o r te d in th e
su m m ary.

Part C: Certification
Line 7. Enter the name and telephone
number of the appropriate individual to
contact regarding the report.
Line 8. Complete the certification. The
report is not valid without a completed
certification.
Instructions for Schedule Bl—Schedule
for Separate Description of Claims
Note.—Be sure to enter the employer
identification number or social security
number of the U.S. claimant from Part A. Line
1. in the space indicated in upper right hand
comer of the schedule. Also enter the number
of this individual Schedule Bl and the total
number of Schedule Bl’a submitted in the
spaces indicated.
Submit an individual Schedule Bl for
each claim or common set of claims.
Claims of an individual person or a
single entity (e.g., a subsidiary! against
the same Iraqi entity involving a
common set of circumstances may be
reported on a single Schedule Bl, with
amounts allocated appropriately to each
category of claim. Three copies of
Schedule Bl are attached to the report.
Additional photocopies o f Schedule Bl
m a y b e u se d , if n e e d e d .
L in es 1-2. E n ter th e n a m e a n d a d d r e s s
o f th e e n tity a c tu a lly su ffe r in g th e lo s s ,
if d iffer en t from th e c la im a n t n a m e d in
P art A . L in e 1 (e.g., a c la im a r isin g from
in ju ry to a su b sid ia r y ).
Line 3. If the entity described in I-in* i

of this Schedule Bl is different than the
claimant named in Part A, Line 1,
include a full description of the
claimant’s ownership interest in the
entity.
Line 4. Identify the Iraqi entity against
which the claim is asserted.
Line 5. E n ter th e v a lu e o f e a c h c la im
in th e a p p r o p r ia te c a te g o r y . R ep o rt th e
c la im in U .S . d o lla r s to th e n e a r e s t
d o lla r. C o n v e r t fo re ig n c u rr en cy v a lu e s
a t th e e x c h a n g e r a te p r e v a ilin g o n th e
d a te o f th e lo s s . In v a lu in g th e c la im s,
u s e e s tim a te d v a lu e s a s o f th e d a te o f
th e lo s s i f p r e c is e v a lu e s or b a la n c e s are
n o t k n o w n . B e su r e to d e s c r ib e y o u r
v a lu a tio n m e th o d s in L in e 0.
L in e ft D e s c r ib e th e c ir c u m s ta n c e s o f
th e lo s3 . In clu d e th e d a te o f th e l o s s an d
a d e s c r ip tio n o f th e p rop erty, b u s in e s s ,
o b lig a tio n , injury, or o th e r d a m a g e
w h ic h is th e s u b je c t o f th e cla im .
Id e n tify a n y o th e r p e r s o n s w ith in te r e sts
in th e c la im a n d a n y a lte r n a tiv e so u r c e s
o f c o m p e n s a tio n a v a ila b le , a c tu a l or
p o te n tia l. D e s c r ib e a n y k n o w n
c o u n te r c la im s th a t p o te n tia lly m a y b e
a s s e r te d b y th e G o v e r n m e n t o f Iraq. If
th e c la im in v o lv e s a c o n tr a c t d isp u te ,




d e s c r ib e a n y c l a u s e s in th e c o n tr a c t
referrin g to c h o ic e o f la w or foru m for
se ttlin g d isp u te s. If th e p ro p erty is o f th e

type for which a specific balance or
generally accepted market quotation
value is not available, indicate the
valuation method used (e.g., contractual
value, book value, estimated value of
similar property). If the property or
obligation i3 valued in a foreign
currency, be sure to specify the currency
and the exchange rate used in the
valuation. Do not submit documentary
evidence with the report
Paperwork Reduction A ct Statement:

The paperwork requirement has been
cleared under the Paperwork Reduction
Act cf 1980. The Office of Foreign
Assets Control of the Department of the
Treasury requires this information be
fumisheid pursuant to 50 U.S.C. 1701,
and 31 CFR Part 575. T h e information
collected will be used for U.S.
Government planning purposes. The
information will be held confidential.
The estimated burden associated with
this collection of information is 3.5 hours
per respondent or recordkeeper.
Comments concerning the accuracy of
this burden estimate and suggestions for
reducing this burden should be directed
to the Blocked Assets Section, Office of
Foreign Assets Control, Department of
the Treasury. Washington. DC 20220 and
the Office of Management and Budget,
Paperwork Reduction Project (15050128), Washington, DC 20503.
R ep o rt o f C la im s b y U S . N a tio n a ls
A g a in s t Iraq

Office of Foreign Assets Control,
Department of the Treasury,
Washington. DC 20220
This form shall be completed and two
copies sent to the above address by
March 1,1991, by all US. nationals who,
on 5:00 p.ra., EST, January 10,1991, had
claims outstanding against the
Government of Iraq, or any Iraqi
Government entity. A third copy shall
be retained by the reporter. READ THE
INSTRUCTIONS CAREFULLY BEFORE
PREPARING THIS REPORT. For
assistance call (202) 535-4020.
Im portant: T h e s u b m is s io n o f th is
rep ort d o e s n o t c o n s titu te th e filin g w ith
th e U .S . G o v e r n m e n t o f a fo rm a l c la im
for c o m p e n s a tio n , n o r does it g u a r a n te e
th at th e c la im w ill b e in c lu d e d in a n y
future a g r e e m e n t or se ttle m e n t.

However, failure to file complete
information in a timely fashion would
not only constitute failure to comply
with Section 575.605 of the Iraqi
Sanctions Regulations (31 CFR part 575)
but would also prevent the inclusion of
the information in U.S. Government
planning and therefore could be

p r e ju d ic ia l to th e in te r e s ts o f th e
c la im a n t a n d o th e r U .S . c la im a n ts.

To the Secretary of the Treasury:
The undersigned, pursuant to 31 CFR
575.605, hereby makes the following
report:
Part A: Information Concerning U.S.
Claimant
1. Name:
EIN/SSN:
2. Address:
3.
State nationality or place of
incorporation. If there has been any
change in nationality status since the
date of the loss, so explain.
4.
If claimant is a corporation or other
legal entity, state date and place of
incorporation, percentage of outstanding
capital stock of ail classes held, directly
or indirectly, by U.S. nationals on the
date of the loss.
5.
If the person reporting the claim is a
person other than the claimant named in
Line 1, state name, address, and
relationship to claimant*
1

Part B: Summary of Claims Against Iraq
6. Claims:
Report the aggregate value of all
claims in the appropriate category or
categories below. Detailed information
concerning specific claims should be
reported on one or more attached
Schedule Bl’s. The sum of all amounts
reported on Schedule Bl should total the
aggregate amount reported in this
summary. Three copies of Schedule Bl
are attached to this pamphlet.
Additional photocopies may be used, if
required.
A. Business Claims:
(1) Loans or credits overdue
or in default..........................................—
(2) Expropriation of equity,
concessions, or going con­
cern value
(3) Expropriation of real and/
or tangible property.—...................-.......
(4) Receivables or other
amounts due and unpaid—.....................
(5) Breach of contract dam­
ages ---------------------------- ------------(8) Other damages..... ......................... ......
. Subtotal A— .—..— ..........-.............. B Personal Claims:
.
(1) Expropriation losses——............... -.....
(2) Salaries, benefits, or other
items due and unpaid.............................

Federal Register / Vol. 5 , No. 28 / Monday, February 11, 1991 / Rules and Regulations
6
(3) Lost future benefits or
other contractual claims......
(4) Personal injury or other
tort claims................. .........
(5) Other damages..................
Subtotal B ............................
Total (Subtotals A. + B.).......

(Date)
EIN or SSN of Claimant:
This is ---(Number of)
(Total Number)
Schedule Bis submitted.

Schedule Bl—Schedule for Separate
Part C: Certification
Description of Claims
7.
Individual to contact regarding this
(See Specific Instructions)
report:
1. Name:
(Namej
2. Address:
(Telephone Number)
8. Certification:
L ---------------------------------------------(Name)
certify that I am the ----------------------(Corporate Title or Position, If Applicable)
of the
-------- -------- (Corporate Name, If Applicable)
that I am authorized to make this
certification, and that, to the best of my
knowledge and belief, the statements set
forth in this report including any papers
attached hereto or filed herewith, are true
and accurate, and that all material facts in
connection with said report have been set
forth herein.
(Signature)




3.
Describe the relationship of this
entity to the claimant named in Part A.

5641

(2) Expropriation of equity,
concessions, or going con­
cern value... .........................................
(3) Expropriation of real an d /
or tangible property....................................
(4) Receivables or other
amounts due and unpaid............................
(5) Breach of contract dam­
ages ................................................................
(8) O ther d am ag es..........................................
Subtotal A.....................................................
B. Personal Claims:
(1) Expropriation losses..................................
(2) Salaries, benefits, or other
items due and u n p aid .................................
(3) Lost future benefits or
other contractual claim s.............................
(4) Personal injury or other
tort claim s......................................................
(5) O ther d am ag es...........................................
Subtotal B ......................................................
Total (Subtotals A. + B.)..............................

6.
Describe the circumstances of the
loss. Include the date of the loss and a
description of the property, business,
obligation, injury, or other damage
5. Type and amount of claim reported which is the subject of the claim. Do net
submit documentary evidence. (See
on this Schedule Bl.
Specific Instructions)
4.
Identify the Iraqi entity against
which the claim is asserted.1

A Business Claims:
(1) Loans or credits overdue
or in default...........................................

[FR Doc. 91-3396 Filed 2-6-91; 8:45 amj
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