CM-07-06-099TEXAS 1033 SURPLUS PROPERTY PROGRAM
Application Packet Instructions
1. LESO — Law Enforcement Agency Data Sheet
Complete the following fields on the LESO Data Sheet
a. Date — enter current date
b. Agency — enter agency's full name
c. Address, City, State, Zip, Email, Phone and Fax — PO Boxes are not authorized
d. Number of Sworn Officers — enter quantity of sworn officers for each sub
category (F/T. P/T, Reserve)
e. Screeners & Weapons POCs — List personnel that are authorized to screen and
receive surplus property
f. Inventory Check — check the appropriate block for the type of loaned property
g. State & Local Agencies — enter Chief Executive Official's Name and Rank
DO NOT ENTER ANY DATA IN THE `FEDERAL AGENCIES' BLOCK
2. TX 1033 — Supplemental Data Sheet
Complete the following fields on the State Data Sheet
a. Date — enter current date
b. Agency — enter agency's full name
c. Phone / Alternate Phone
d. Fax
e. Website
f. Screener's Data
g. Weapons Officer's Data
h. Agency Chief Executive Official — enter Name, Title and Email address
i. Authorized Official — enter Name, Title and Email address
3. TX 1033 — Application Letter
Read and complete the following fields on the Application Letter
a. Agency — enter agency's full name
b. Agency Chief Executive Official — enter Date, Name and Title of official
c. Authorized Official — enter Date, Name and Title of official
4. TX 1033 — Release of Liability
Read and complete the following fields on the Release of Liability
a. Agency — enter agency's full name
b. City / County — enter the city and county the applicant agency resides
c. Agency Chief Executive Official — enter Date, Name and Title of official
d. Authorized Official — enter Date, Name and Title of official
Print each form for signature:
The Agency Chief Executive Official is required to sign each form on the
designated area.
The Authorized Official is required to sign the Supplemental Data Sheet,
Application Letter and Release of Liability on the designated area.
ern. -oil -o4 -Mg
LAW ENFORCEMENT AGENCY
DATA SHEET
FEDERAL AND STATE
DATE:
June 01, 2007
AGENCY:
Round Rock Police Department
ADDRESS(No P.O. Box):
CITY:
ZIP:
PHONE:
Round Rock
615 East Palm Valley
78664
(512)-218-5500
EMAIL:
STATE:
Texas
FAX:
(512)-218-6681
FULL TIME:
158
NUMBER OF SWORN OFFICERS
PART TIME: RESERVE:
SCREENERS & WEAPONS POCS MUST BE AUTHORIZED IN WRITING BY THE GOVERNOR
APPOINTED STATE COORDINATOR
Sergeant Nathan Zoss nzoss@round-rock.tx.us
Officer Mike Losoya mlosoya@round-rock.tx.us
SCREENER #1:
SCREENER #2:
SCREENER #3:
SCREENER #4:
WEAPONS POC:
Officer Brent Smith ssmith@round-rock.tx.us
Inventory Check
Does the Agency currently have any Equipment from the 1208/1033 Program: " YES r NO
Weapons: r YES r' NO
Aircraft: r YES rNO
APCs:
FX YES r NO
By signing this request, the Chief Executive Official or Head of Agency is aware of property
currently in the possesion of their department.
STATE & LOCAL AGENCIES
CHIEF EXECUTIVE OFFICIAL SIGNATURE:
STATE COORDINATOR SIGNATURE:
HEAD OF AGENCY SIGNATURE:
FEDERAL AGENCIES
TEXAS 1033 SURPLUS PROPERTY PROGRAM
SUPPLEMENTAL DATA SHEET
Date: ;limp 01, 2007
Agency:Round Rock Police Department
Phone: ( 512) 218- 5500Alternate Phone: ( 512) 218- 6667
Fax: (512 218. 6681
Website (if applicable): I,rrp: //www. roundrocktexas.gov/police
Screener #1:
Screener #2:
Screener #3:
Screener #4:
Sergeant Nathan Zoss
RANK / NAME / E-MAIL ADDRESS
Officer Mike Losoya
RANK / NAME / E-MAIL ADDRESS
RANK / NAME / E-MAIL ADDRESS
RANK / NAME / E-MAIL ADDRESS
Weapons Officer: Offs ger Brent Smith
RANK / NAME / E-MAIL ADDRESS
nzoss@round-rock.tx.us
mlosoya@round-rock.tx.us
ssmith@round-rock.tx.us
AGENCY CHIEF EXECUTIVE OFFICIAL'
Signature:\ k,r‘ iO L -4) ---
Name: Bryan H. Williams
Title: Chief of Police
Email: bwilliams@round-rock.tx.us
A THORIZED OFFICIAL2
Signature:
Name:
Title:
Email: jnuse@round-rock.tx.us
m Nuse
City Manager
-$-07
1 Agency Chief Executive Official - Chief of Police or County Sheriff.
2 Authorized Official - County Judge, Mayor, or City Manager/Administrator, University/College
President or Director.
TX 1033 Form Al JUNE 2007
TEXAS 1033 SURPLUS PROPERTY PROGRAM
APPLICATION LETTER
TO: JFTX-LES-CD/1033
ATTN: Texas 1033 Program
2200 W. 35TH Street
BLDG 41
Austin, TX 78703
AGENCY: Round Rock Police Department
SUBJECT: Request Authorization for Screening and Receiving Surplus Property
1. Our Agency request that the personnel listed on the attached Law Enforcement Agency
(LEA) Data Sheet be granted authorization to screen for and receive excess federal property as
defined in the Defense Authorization Act, 1997, Public Law 104-181 Section 1033, Transfer of
Excess Personal Property.
2. We, the undersigned, understand and agree that failure to comply with the terms of this
application is in direct conflict with the intent of this program, and failure on our agency's part to
abide by the terms and conditions of the Texas 1033 Program may result in termination from the
program and other sanctions including civil or criminal prosecution.
3. We understand and agree that we are responsible for all transportation costs incident to the
redistribution or collection of any transferred property. Transferred property must be removed
from the Defense Reutilization and Marketing Offices (DRMO) within fourteen (14) days or
sooner if so directed by the DRMO. Failure to claim and remove property may result in the
redistribution of the property to another agency.
4. We understand and agree that this property is transferred from the Department of Defense
(DoD). Transferred property must have a direct application to the LEA's street law enforcement,
arrest and apprehension mission. Transferred property may not be disposed of, bartered or
transferred without prior notification, written authorization and instructions from the Texas 1033
Program, including instances in which property is no longer serviceable for law enforcement use.
5. We understand and acknowledge that at no time can transferred aircraft or weapons be sold.
Additionally, assigned aircraft or weapons can not be disposed of, bartered or transferred without
written consent from the Texas 1033 Program. Failure to comply will result in eternal
termination from the program and possible civil or criminal prosecution.
6. We have read and understand, in its entirety, the Texas Military Surplus Property and
Procurement Program booklet. We understand and agree to comply with the terms and
conditions of the Texas 1033 Program and have signed the Release of Liability Statement.
7. We understand that the Federal Freedom of Information Act and the Texas Open Records
Act apply to all property received under the Texas 1033 Program.
n " O'7- i
TX 1033 Form A2 z00'7
1 of 2
8. We understand and agree that our authorization to screen and receive property expires one
year from the Law Enforcement Support Office (LESO) authorization letter date. We also
understand that it is our responsibility to submit a new Texas 1033 Program application packet
each year prior to the one year anniversary of our Authorization Letter and/or when there are
administration changes and a new LEA Data Sheet when there are any personnel changes.
Failure to comply may result in suspension from the program and possible teimination.
9. We understand that the inventory form (TX 1033 Form A6) will be completed and
maintained for all transferred property. Additionally, we acknowledge that the inventory form
must be submitted annually with the application packet to maintain compliance with program
policies. Failure to comply may result in suspension of the program and possible termination.
10. We understand that if a vehicle is obtained through the Texas 1033 Program, the LEA will
forward photocopies of both (1) the United States Government Certificate to Obtain Title to a
Vehicle (SF 97); and (2) the Texas Certificate of Title (Form 30-C) to the Texas 1033 Program
Office within thirty (30) days of receipt.
AGENCY CHIEF EXECUTIVE OFFICIAL':
21A414Arx
Signature
Bryan H. Williams, Chief of Police
Name / Title
AUTHORIZED OFFICIAL2:
S ture
JArnes 11%u5E,1?6.) 6iTy17)Ati'AgEk,
Name / Title
64,101010-1
Date
10-8 -97
Date
1 Agency Chief Executive Official — Chief of Police or County Sheriff.
2 Authorized Official — County Judge, Mayor, or City Manager/Administrator,
University/College President or Director.
TX 1033 Form A2 JUNE 2007
2 of2
TEXAS 1033 SURPLUS PROPERTY PROGRAM
RELEASE OF LIABILITY
AGENCY:
Roundf94-ice Department
Round Rock/Williamson
City / County
, Texas
The Texas Law Enforcement Agency (LEA) designated above acknowledges receipt of excess
property from the Department of Defense pursuant to Section 1033 of the National Defense
Authorization Act for Federal Fiscal Year 1997 (the "Act"). Such excess property transferred
pursuant to the Act may include small arms and ammunition (hereinafter referred collectively as
the "Transferred Property").
The LEA acknowledges that the Transferred Property is considered excess to the needs of the
Department of Defense and that the Transferred Property may be in any condition from new to
unserviceable. The LEA acknowledges that there may be hazards associated with the use of the
Transferred Property, which could cause damage to property and serious injury or death. The
term "use" with respect to the Transferred Property is acknowledged to include, but is not limited
to, active deployment, passive transportation, and mere possession. The LEA agrees to provide
appropriate or adequate training to any person who may use the property. The LEA agrees that it
IS NOT the responsibility of the Department of Defense, the State of Texas or the Texas Joint
Military Forces to provide appropriate or adequate training to any person using the Transferred
Property.
The Department of Defense, the State of Texas nor the Texas Joint Military Forces assumes any
liability for damages or injuries to any person or property arising from the use the Transferred
Property. By signing this agreement, the LEA agrees to be solely responsible for any and all
suits, actions, demands or claims of any nature arising from the use of the Transferred Property.
The LEA agrees to maintain, at its expense, adequate liability and property damage insurance
and workman's compensation insurance to cover any such claims.
The LEA accepts Transferred Property "as is" with no warranty of any kind. The Department of
Defense, the State of Texas nor the Texas Joint Military Forces make any claims or warranties,
expressed or implied, concerning the Transferred Property, including but not limited to warranty
of fitness for a particular purpose.
The LEA acknowledges that any item of the Transferred Property meeting the definition of
"machine gun" found in 26 U.S. C. 584(b)* must be registered with the Bureau of Alcohol,
Tobacco, and Firearms (BATF) with an ATF Form -10 (Application for Registration of Firearm
Acquired by Certain Governmental Entities). Upon receipt of a properly executed Form -10,
ATF will accept the registration of the machine gun and notify the LEA. Any machine gun
registered in this manner is restricted for law enforcement use only. The LEA agrees to provide
the State Coordinator's Office a copy of an approved Form -10 for each machine gun that is part
of any Transferred Property received. The LEA must execute a separate transfer agreement with
the United States Army, through the 1033 Program, for any small arms/weapons.
The LEA acknowledges that it is solely responsible for any and all costs associated with the
transferred Property, including but not limited to, packing, crating, handling, transportation,
repossession, and disposal.
TX 1033 Form A3 JUNE 2007
1 of2
The LEA acknowledges that Transferred Property may be disposed of only with written approval
from the State Coordinator's Office and in accordance with local, state, federal laws, and the
regulations and guidelines of the 1033 Program prescribed by the Law Enforcement Support
Office. The LEA specifically acknowledges that the preceding rule includes, but is not limited to
the transfer, destruction or abandonment of any Transferred Property constituting small
arms/weapons and weapons parts.
Subject to the conditions set forth herein, title to the Transferred Property is assumed by the LEA
upon written acceptance hereof from the LEA.
By signing below, the Agency Chief Executive Official and the Authorized Official
acknowledge and understand all previously stated guidelines and conditions.
AGENCY CHIEF EXECUTIVE OFFICIALI:
AAA iebn. k.)009,Lbr.Y1/4 VleiVWD/
Signature k Date
Bryan H. Williams, Chief of Police
Name / Title
AUTHORIZED OFFICIAL2:
S ature Date
�lilmes R. Aki6) P. 1 T y mfi-mil6-6-e,
Name / Title
* The National Firearms Act, 26 U.S.C. section 5801 et seq., defines a firearm to include
machine gun. 26 U.S.C. Section 5845(a)(6). That same act, defines a machinegun as follows:
The term "machine gun" means any weapon which shoots, is designed to shoot, or can be
readily restored to shoot, automatically more than one shot, without manual reloading, by a
single function of the trigger. The term shall also include the frame or receiver of any such
weapon, any combination of parts designed and intended, for use in converting a weapon into a
machine gun, and any combination of parts from which a machine gun can be assembled if such
parts are in the possession or under the control of a person.
1 Agency Chief Executive Official — Chief of Police or County Sheriff.
2 Authorized Official — County Judge, Mayor, or City Manager/Administrator,
University/College President or Director.
TX 1033 Form A3 JUNE 2007
em -i -062-0q
2 of2
CITY MANAGER BLUE SHEET FORMAT
PLEASE BE SURE ALL AREAS OF THIS FORM HAVE BEEN FILLED OUT.
DATE: June 1, 2007
SUBJECT: City Manager Approval
ITEM: Texas 1033 Surplus Property Program
The Police department has participated for years in the 1033
Program, a US government program that allows eligible law
enforcement agencies to obtain free surplus military equipment.
Department:
Staff Person:
,justification:
Police Department
Nathan Zoss/Sherrill Voll
We must update our "Law Enforcement Data Sheet" which
details how many officers we have as well as other
statistical information about the Department. Our staffing
levels affect how much equipment we are authorized. This
update requires signatures from the Chief of Police and the
City Manager. Also needed is the 1033 Program Application
The state office that administers the program has adopted
a policy requiring each agency participating to complete
the application on a yearly basis.
Funding:
Cost: $0.00
Source of funds: N/A
Background Information: Over the past several years the Round Rock
Police Department has obtained numerous
amounts of equipment such as night vision
equipment, weapons, blankets and cots for
disaster relief, computers and other
miscellaneous needed equipment.
Updated 3-10-05