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Arrested Person's Name
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A Number
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Date of Birth
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-
Month
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Day
Year
Date
Country of Origin
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Current Location
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Contact Information of family or friend of arrested person (please include name, relationship to arrested person, and phone number)
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In what city and state did ICE arrest the person?
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In what location did ICE arrest the person? For example, home, work, vehicle, public area?
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Has the person been previously removed from the United States?
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Yes
No
I don't know
Does the person have an existing removal order?
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Yes
No
I don't know
Description of the arrest (e.g., summary of any questioning; whether ICE stated they had a warrant; whether ICE was wearing a uniform and identified themselves; whether ICE asked for consent to question and explained that the person was under arrest; any use of force or intimidation)
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Community ties (e.g., family members that the person lives with or cares for; length of residence in the United States; home ownership or rental; employment history)
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Upload the arrested Person's I-213 and/or any other supporting documents (up to 5). Maximum file size is 10MB.
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