Designation of Attorney In Fact

• Legal Form Number: I-312
• Section: U.S. Immigration and Customs Enforcement
• Issuer: U.S. Immigration and Customs Enforcement

DEPARTMENT OF HOMELAND SECURITY

U.S. Immigration and Customs Enforcement

DESIGNATION OF ATTORNEY IN FACT

(To accept on Obligor's behalf the return of cash deposited to secure an immigration bond and interest accrued upon final action being

taken by ICE on the bond)

Bonded Alien A-File No.

Bond No. (From Form I-305 or I-352)

a refund of the deposit of cash in the amount of $

IN WITNESS WHEREOF, I have hereto set my hand and seal on the

The reason why I am making this designation of attorney in fact is because:

Signature of Obligor (Principal) (Sign in ink)

Name, Address, TIN or SSN for Attorney in Fact:

On the day of in the year before me personally came

(Obligor) to me known and known to me to be the individual described in and who executed the foregoing instrument and

acknowledged to me that s/he executed the same for the use and purpose therein contained.

ICE Form I-312 (3/23) Page 1 of 2

I, , of , am the obligor on Bond No.

. As the obligor and principal on this bond, I designate

(Attorney in Fact) of

I am aware that I remain the obligor on this bond, and as such, I continue to have all obligations under the bond agreement, including

the obligation to update my address with U.S. Immigration and Customs Enforcement (ICE) so that I can receive bond notifications

which may require my action. Further, I recognize that as the obligor I am responsible for any tax due on the interest accrued on this

bond. This designation will not be effective unless it is properly notarized, and until the original form is received by the Bonds Section at

Financial Service Center - Burlington, ICE, P.O. Box 5000, Williston, VT 05495, its validity confirmed, and it is entered into an ICE

database. If this designation is invalid, the Bonds Section will return it to me with a brief explanation of why it is not acceptable.

made by me on

, and interest that has accrued. I give and grant

as security for

day of in the year .

an immigration bond for the release of

unto my said attorney full power and authority to do and perform acts necessary to be done, to receive the proceeds of this bond once

ICE has taken final action.

my true and lawful attorney and in my stead to receive

STATE OF

COUNTY

Notary Seal

My commission expires:

Notary Public, State of

EXAMINED AND APPROVED AS TO LEGAL FORM

AND EXECUTION AND ACCEPTED.

DATE

OMB No. 1653-0041

Exp. 02/28/2026

Do Not Write in this Space - Agency Only