IMMIGRATION COURT

________________________ DETENTION FACILITY

CUSTODY REDETERMINATION QUESTIONNAIRE

 

BRING COMPLETED QUESTIONNAIRE TO COURT

 


Date:_________________

 


A#______________ ALIEN’S NAME___________________ AGE:_____ CURRENT STATUS_________

 

ATTORNEY/WAIVED:________________________________ T/A____________________________________

 

BOND REQUESTED:_______________FIRST ENTRY DATE________________ LAST ENTRY DATE__________________

 

BONDED ADDRESS/OWNER:_______________________________________________________________________________ __________________________________________________________________________________________________________

 

MARITAL STATUS:____________ SPOUSE’S VISA STATUS:___________

 

FAMILY IN THE U.S./STATUS:______________________________________________________________________________

___________________________________________________________________________________________________________

 

LEVEL OF EDUCATION:____________________________________________________________________________________

 

LAST U.S. EMPLOYMENT & DATES:________________________________________________________________________

 

PRIOR U.S. EMPLOYMENT & DATES:________________________________________________________________________

 

DOES RESPONDENT HAVE AUTHORIZATION TO WORK IN THE U.S. (YES/NO) ______________________

 

PROPERTY OWNED:________________________________________________________________________________________

 

ARRESTS/CONVICTIONS & DATES:_________________________________________________________________________

___________________________________________________________________________________________________________

 

DATE RELEASED FROM MOST RECENT CRIMINAL CUSTODY: _______________________________________________

 

DATE AND MANNER CAME INTO INS CUSTODY:____________________________________________________________

 

PRIOR INS HISTORY:______________________________________________________________________________________

 

PRIOR APPEARANCE/BOND HISTORY:_____________________________________________________________________

__________________________________________________________________________________________________________

POSSIBLE WAIVERS:______________________________________________________________________________________

__________________________________________________________________________________________________________

IMMIGRATION JUDGE’S NOTES: