BOND WORKSHEET

Alien’s name: __________________________ Alien number: A_____-______-_______

Attorney’s name: _______________________ Phone number: ( ) _____-__________
Interpreter requested: (yes/no); Language: _________________
Initial bond set: $________ Bond requested: $_________

EQUITIES

Age: __________ Marital Status: _______________ Date of marriage: ___________

Spouse’s status: ____________ Children (yes/no) Number of children: _____________

List children’s names, dates of birth, and places of birth (attach copies of birth certificates):

_______________________, ________________, ___________________________________

_______________________, ________________, ___________________________________

_______________________, ________________, ___________________________________

Use additional sheets if necessary

Birthplace of mother: ______________________ Birthplace of father: ___________________

Status of mother: _________________________ Status of father: _______________________

Will respondent make any claims of citizenship to the United States? (yes/no)
Will the claim be by birth (in U.S.), naturalization, acquisition or derivation? ______________

Does respondent have any brothers/sisters in the United States? (yes/no)

List siblings’ names, dates of birth, and status(es) in the United States:

______________________, _________________, ____________________________________

______________________, _________________, ____________________________________

______________________, _________________, ____________________________________

Use additional sheets if necessary

First date respondent entered United States: ______________ Current status: _______________

Years resided in U.S.: ______ Date received permanent residence: _____________________

Education received (both in U.S. and elsewhere): _____________________________________

Use additional sheets to lists schools attended, graduation dates, etc.

Has respondent been employed in the United States? (yes/no)

Does respondent have authorization to work in the United States? (yes/no)

Has respondent ever used illegal documentation to work in the United States? (yes/no)

List last three places of employment, dates of employment, and last salary received:

_____________________________, __________________, ____________________________

_____________________________, __________________, ____________________________

_____________________________, __________________, ____________________________

Where will respondent reside if released? ___________________________________________

With whom will respondent reside? ________________________________________________

List all convictions of, dates of convictions, sentences received, and time served by respondent

__________________________, ______________, _______________________, ___________

__________________________, ______________, _______________________, ___________

__________________________, ______________, _______________________, ___________

Date respondent came into custody of the Immigration Service: __________________________

How did respondent come into Immigration Service custody? ___________________________

Is respondent subject to mandatory custody provisions of section 236 (c) of the Act? (yes/no)

List all forms of relief which respondent will seek: __________________________________,

__________________________________________, _________________________________,

__________________________________________, _________________________________.

Other considerations: ___________________________________________________________

____________________________________________________________________________.