Obligor Change of Address

• Legal Form Number: I-333
• Section: U.S. Immigration and Customs Enforcement
• Issuer: U.S. Immigration and Customs Enforcement

DEPARTMENT OF HOMELAND SECURITY

U.S. Immigration and Customs Enforcement

OBLIGOR CHANGE OF ADDRESS

INSTRUCTIONS:

In order to assist in the management of your bond please file this form for each bond for which you are the obligor.

This form may be presented in person and upon presentation a signed copy will be returned to you indicating receipt of the change of

address. However, you may mail this form to the Enforcement and Removal Office in which you posted your bond

(www.ice.gov/contact/ero/).

In addition the law requires that all non-United States citizens (i.e., bonded aliens) present in the U.S. for more than 29 days present a

notice of a change of address (Alien's Change of Address Card, Form AR-11).

Today's Date:

TYPE OR PRINT THIS FORM

File Number:

Bond Receipt Number:

Name of Alien:

Obligor's Name:

Alien's Current Physical Address

Obligor's New Address

Number/Street/Apt.:

State/ZIP Code:

Telephone Number:

Alien's Telephone Number:

Obligor's Signature (Sign in ink):

X

DHS Official Receiving Change of Address

Name:

Title:

Location:

Signature (Sign in ink):

X

ICE Form I-333 (4/20)

3 Copies: Original - A File, Obligor, Burlington Finance Center

City:

Number/Street/Apt.:

City:

State/ZIP Code:

Privacy Notice

Authority: The collection of this information is authorized by The Immigration and Nationality Act, as amended (8 U.S.C. 1103, 1183, 1226, 1229c, and 1363).

Purpose: This form is submitted by bond obligors who need to inform ICE of a new mailing address. ICE needs to maintain current obligor address information so that it can

communicate with the obligor and make payments of interest and principal owed to the obligor.

Agency Disclosure of Information: For United States Citizens, Lawful Permanent Residents, or individuals whose records are covered by the Judicial Redress Act of 2015 (5

U.S.C. § 552a note), your information may be disclosed in accordance with the Privacy Act of 1974, 5 U.S.C. § 552a(b), including pursuant to the routine uses published in the

DHS/ICE-004 Bond Management Information System of Records Notice (BMIS SORN), which can be viewed at www.dhs.gov/privacy.

For all others, as appropriate under United States law and DHS policy, the information you provide may be shared internally within the U.S. Department of Homeland Security

(DHS), as well as federal, state, local, tribal, territorial, and foreign law enforcement; other government agencies; and other parties for collection, enforcement, investigatory,

litigation, or other purposes.

Providing Information to DHS: Furnishing this information is voluntary. However, ICE may be unable to communicate with or make appropriate payments to the obligor if this

information is not provided.

OMB No. 1653-0042

Expiration: 04/30/2022

Page 1 of 1

Public Reporting Burden. The U.S. Immigration and Customs Enforcement is collecting this information as a part of its agency mission under the Department of Homeland

Security. The estimated average time to review the instructions, search existing data sources, gather and maintain the data needed and completing and reviewing this collection

of information is 15 minutes (.25 hours) per response. An agency may not conduct or sponsor, and a person is not required to respond to, an information collection unless it

displays a currently valid OMB Control Number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for

reducing this burden to the Department of Homeland Security, U.S. Immigration and Customs Enforcement, P.O. Box 5000, Williston, VT 05495. OMB No. 1653-0042. (Do not

mail your completed application to this address.)