A copy of the immigration bond form found at the ICE (U.S. Immigration and Customs Enforcement) website:
DEPARTMENT OF HOMELAND SECURITY U.S. Immigration and Customs Enforcement
IMMIGRATION BOND
OMB No. 1653-0022; Expires 04/30/2013
INSTRUCTIONS (READ INSTRUCTIONS CAREFULLY)
This bond is posted as security for performance and fulfillment of the bonded alien’s obligations to the government. An acceptable surety company or an entity or individual who deposits United States bonds, notes, or cash may execute the bond as surety. The surety is the obligor; the bonded alien is the principal; and DHS is the beneficiary of all bonds it authorizes. The obligor guarantees the performance of the conditions of the bond. The bond’s guaranty is secured by the amount of the bond. An acceptable surety company is one that appears on the current Treasury Department Circular 570 as a company holding the requisite certificate of authority to act as a surety on Federal bonds. An agent of an acceptable surety company may execute the bond only if the agent attaches to the bond a currently valid power of attorney showing the authority of the agent to act for the surety company. Powers of Attorney do not have official form numbers. They differ from state to state and from company to company. Any agent of an acceptable surety company is a co-obligor on this bond, and he/she shall sign as a co-obligor in paragraph D. Failure of an agent to sign as co-obligor shall result in rejection of the bond. A co-obligor shall be jointly and severally liable with the surety company for any breach of this bond (i.e., the liability of a co-obligor is in addition to, not instead of, that of the obligor). DHS may refuse to accept any bond to the extent permitted by law.
Obligors and co-obligors (if any) shall state their full name and address in Paragraph A, and shall sign the bond where indicated in Paragraph D. Obligors and co-obligors are required to submit Form I-333, “Obligor Change of Address,” (available on the ICE website) pursuant to the instructions on the form whenever the obligor has a change of address. Either the obligor or co-obligor, or both, may be corporate entities. In addition, an obligor who deposits United States bonds, notes, or cash must deposit the requisite security and execute the appropriate Power of Attorney (i.e., either Paragraph H or I). This deposit and execution may be made before two officers or employees of the Department of Homeland Security (“DHS”) who have been authorized to administer oaths pursuant to 8 U.S.C. 1357, and who shall sign as witnesses in Paragraph J. A notary public may witness the obligor’s signature in either Paragraph H or I by affixing his/her notarial seal where indicated and showing the date his/her commission expires. No seal is required when officers or employees of the DHS witness the transaction. When a notary public witnesses the obligor’s signature, DHS witnesses must still acknowledge receipt of the security for the bond in Paragraph J.
Only the owner of record may deposit United States bonds or notes. Such bonds or notes must be negotiable and not redeemable within one year of the date of the deposit. Any charges made by the depository for accepting United States bonds or notes must be borne by the alien or the owner of the security.
PRIVACY ACT STATEMENT
Authority and Purpose: The Immigration and Nationality Act, as amended, (8 U.S.C. 1103, 1183, 1226, 1229c, and 1363) authorizes the collection of this information to provide for the posting, maintenance, cancellation, and breach of an immigration surety bond, and for associated financial management activities, including collection of unpaid monies, reimbursement of the bond principal, and the calculation, payment, and reporting of interest. The Internal Revenue Code (26 U.S.C. 6109) and Executive Order 9397 authorize the collection of the Social Security number (SSN).
Disclosure: Furnishing this information is voluntary; however, failure to provide it will result in the non-issuance of the immigration bond. For cash bonds, your SSN is necessary to pay interest through the U.S. Treasury Department and to comply with Internal Revenue Service requirements to report interest payments.
Routine Uses: This information will be used by and disclosed to DHS personnel and contractors or other agents who need the information to support the enforcement of immigration laws and the provision of immigration benefits. DHS may share this information with the U.S. Treasury Department to report interest paid to an obligor, and to facilitate payments to or collection of monies owed by an obligor. DHS may also share this information with the U.S. Justice Department and other Federal and State agencies for collection, enforcement, investigatory, or litigation purposes, or as otherwise authorized pursuant to its published Privacy Act system of records notice.
Public Reporting Burden. Under the Paperwork Reduction Act, an agency may not sponsor an information collection and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. We try to create forms and instructions that are accurate, can be easily understood, and which impose the least possible burden on you to provide us with information. Often this is difficult because some immigration laws are very complex. The estimated average time to complete and file this application is 30 minutes per application. If you have comments regarding the accuracy of this estimate, or suggestions for making this form simpler, you can write to:
Office of the Chief Financial Officer/OAA/Records Branch US Immigration and Customs Enforcement 500 12th ST SW STOP 5705 Washington DC 20536-5705 (Do not mail your completed application to this address.)