Request for Immigration Bond Information by Alien

• Legal Form Number: 71-051
• Section: U.S. Immigration and Customs Enforcement
• Issuer: U.S. Immigration and Customs Enforcement

DEPARTMENT OF HOMELAND SECURITY

U.S. Immigration and Customs Enforcement

REQUEST FOR IMMIGRATION BOND INFORMATION BY ALIEN

For aliens, use this form to request information about an immigration bond posted on your behalf.

I certify under penalty of perjury that the information above is accurate. I authorize U.S. Immigration and Customs Enforcement (ICE),

its offices, employees, contractors, agents, and assignees, to disclose the information or records specified above. I understand this may

include and is not limited to reports, evaluations, and notes of any kind, contained in any record keeping system maintained by or on

behalf of ICE; that ICE retains the discretion to decide if particular records or information are within the scope of this request; and that

ICE has no control over use or dissemination of my information once it is provided to me. I agree to release and hold harmless ICE, its

offices, employees, contractors, agents, and assignees, from any and all claims of action or damages of any kind arising from, or in any

way connected to, the release or use of any information or records pursuant to this request. Certain information about you may be

requested to confirm you identity.

STEP 1 Provide information about yourself.

Full Name Alien Registration Number

Current Address Date of Birth

Country of Birth

STEP 2 Specify the information you are requesting.

Bond Status

Obligor Name

Bond Amount

Other:

STEP 3 Sign the statement below authorizing the release of your information and/or records.

Your Signature (Sign in ink) Witness Signature (Sign in ink)

Date Witness Name

STEP 4 Mail request to:

Financial Service Center – Burlington

Bonds Section

U.S. Immigration and Customs Enforcement

P.O. Box 5000

Williston, VT 05495

ICE Form 71-051 (5/18) Page 1 of 2