Registration

Complete this now so we can act immediately if you or a loved one is detained.

This form is protected by the attorney-client privilege. Please complete all fields as accurately as you can.

Section 1. Detainee Identification & Contact

Full legal name (Last, First, Middle) *

Preferred name / alias

Date of birth *

Country of birth *

Country of citizenship / nationality *

Gender

A-Number (Alien Registration Number)

USCIS / ICE file number

Social Security Number (if any)

Passport number & country issued

Other names / aliases / prior names used

Primary language spoken

Other languages spoken

Does the detainee require an interpreter?

Any hearing, vision, or communication disability requiring accommodation?

Contact Information

Current detention facility name & address

Detention facility phone

Pod / unit / housing location

Personal phone (if accessible while detained)

Email address (if accessible while detained)

Proposed release address (street, city, state, zip)

Section 4. Family Ties, Community Roots & Support Network

Immediate Family Members

Does the detainee have a U.S. citizen or LPR spouse?

U.S. citizen or LPR children (under 21)?

U.S. citizen or LPR parents?

Names and ages of any minor children in the U.S. (citizen / LPR / undocumented)

Residence & Community Ties

Last known U.S. address (street, city, state, zip)

Length of time at that address

Owner or renter?

Total length of time in the United States

Length of time in current community

Does the detainee own real property in the U.S.?

Does the detainee have a valid U.S. driver's license?

Employment & Financial Ties

Currently employed or self-employed?

Employer name

Employer phone

Job title / occupation

Length of employment

Does the detainee have a U.S. bank account?

Does the detainee own a business in the U.S.?

Community & Religious Ties

Member of a church, mosque, temple, or other religious community?

Involved in any civic, cultural, or community organizations?

Names of organizations and leadership contacts (for potential support letters)

Other community ties relevant to bond (volunteer work, schools, professional licenses, etc.)

Section 5. Bond Hearing Information & Financial Details

Has a bond hearing been held in this current period of detention?

Date of prior bond hearing

Immigration court / EOIR location

Immigration judge name

Hearing result

Was bond denied?

Basis for denial (mandatory detention, flight risk, danger to community, other)

Was a bond amount set?

Bond amount set ($)

Was bond paid?

Reason bond was not paid / additional explanation

Previously released on bond or own recognizance (OR)?

Complied with all prior bond conditions (appeared for all hearings)?

Explain any failures to appear or bond revocations

Current Bond Eligibility Assessment

ICE may classify a detainee as subject to mandatory detention under INA Sec. 236(c) based on certain criminal grounds. A bond hearing may still be sought under Jennings v. Rodriguez / Joseph hearing procedures. Counsel will evaluate mandatory detention eligibility based on the complete record.

Has ICE designated this detainee as subject to mandatory detention?

ICE mandatory detention basis (if stated)

ICE detainer / case number

Is there a final order of removal in the record?

Pending appeal or motion to reopen affecting bond eligibility?

Financial Information: Bond Payment Capacity

Approx. monthly household income

Primary income source

Does the family have savings readily available to pay bond?

Estimated available savings ($)

Maximum amount family can pay ($)

Is the family considering a surety / bond company?

Name of proposed bond payor / co-signer and relationship to detainee

Bond payor phone number

Bond payor immigration status

Proposed conditions of release (check all client can comply with)

Other proposed conditions or notes on compliance ability

Upcoming Court Dates

Next scheduled hearing date

Hearing type

Immigration court address

Judge / courtroom number

Pending motions or filings currently before the court

Thank you. Your registration has been received.

Our team will review your information and contact you as soon as possible. If this is an emergency, please call us now.

Call 1-844-3ICEHELP

Registration

Contact Information

Immigration Applications & Proceedings

Prior Removal or Deportation History

Current Detention

Arrests & Criminal Charges

Convictions

Sentence & Incarceration

Outstanding Legal Matters

Gang & National Security