Voluntary Departure And Verification Of I 210 Ice Form
User Manual: I-210
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Date
Office
DEPARTMENT OF HOMELAND SECURITY
U.S. Immigration and Customs Enforcement
VOLUNTARY DEPARTURE AND VERIFICATION OF DEPARTURE
To: (Alien's Last Name, First Name, Address)
You have violated the terms of your admission as a nonimmigrant. Consequently, the permission previously granted you to remain in
the United States is rescinded. You are required to depart from the United States at your own expense on or before .
you were granted voluntary departure by the On IJ BIA DHS. You are required to depart from the
United States on or before at your expense. at government expense. under safeguard.
Your request for an extension of time to depart from the United States has been . You are
(Granted/Denied)
required to depart on or before .
You state that you will be departing the United States on through
(Port of Departure)
on
(Give Airlines, Flight Number and Time or Other Manner of Departure)
Signature of Authorized DHS Official
Alien's Acknowledgement of Conditions and Receipt of Form
(Photo of Alien) (Right Index Fingerprint)
Verification of Departure
(Completion by an official of the Department of Homeland Security or the U.S. Department of State)
ICE Form I-210 (08/08)
Office Date Phone Number
Alien's Phone Number
A: Number
FIN Number
To any U.S. official: This document can be completed and transmitted to DHS/ICE Headquarters Office of Detention and Removal
via VD-Bond-Verifications@dhs.gov .
Additionally, if an Immigration Bond has been posted on the alien, the DHS will initiate the appropriate action in accordance with
the terms of the executed bond and any attached rider or riders specified.
NOTICE: The Immigration Judge's Alternate Order of Removal will take effect if the alien does not depart within the time
specified. Failure to depart on or before the specified date may result in the withdrawal of voluntary departure and action being
taken to effect your removal. A warrant for your arrest will be issued if this office has not received verification of your departure
by the specified date. Failure to depart on or before the specified date may also subject you to a possible civil penalty of not less
than $1,000 and not more than $5,000, and render you ineligible for a period of 10 years for any further authorization for voluntary
departure or for relief under sections 240A, 245, 248, and 249 of the Immigration and Nationality Act.
If
Available
Printed Name/Title Signature of Official Verifying Identity
U.S. Departure Place
Method of Departure
Date
Comments
A-File Copy
TrainAir Boat Other:
DHS Official Serving Form (Name and Title)
Date
ICE Form I-210 (08/08)
Alien Copy
Date
Office
DEPARTMENT OF HOMELAND SECURITY
U.S. Immigration and Customs Enforcement
VOLUNTARY DEPARTURE AND VERIFICATION OF DEPARTURE
To: (Alien's Last Name, First Name, Address)
You have violated the terms of your admission as a nonimmigrant. Consequently, the permission previously granted you to remain in
the United States is rescinded. You are required to depart from the United States at your own expense on or before .
you were granted voluntary departure by the On IJ BIA DHS. You are required to depart from the
United States on or before at your expense. at government expense. under safeguard.
Your request for an extension of time to depart from the United States has been . You are
(Granted/Denied)
required to depart on or before .
You state that you will be departing the United States on through
(Port of Departure)
on
(Give Airlines, Flight Number and Time or Other Manner of Departure)
Signature of Authorized DHS Official
Alien's Acknowledgement of Conditions and Receipt of Form
(Photo of Alien) (Right Index Fingerprint)
Verification of Departure
(Completion by an official of the Department of Homeland Security or the U.S. Department of State)
Office Date Phone Number
Alien's Phone Number
A: Number
FIN Number
To any U.S. official: This document can be completed and transmitted to DHS/ICE Headquarters Office of Detention and Removal
via VD-Bond-Verifications@dhs.gov .
Additionally, if an Immigration Bond has been posted on the alien, the DHS will initiate the appropriate action in accordance with
the terms of the executed bond and any attached rider or riders specified.
NOTICE: The Immigration Judge's Alternate Order of Removal will take effect if the alien does not depart within the time
specified. Failure to depart on or before the specified date may result in the withdrawal of voluntary departure and action being
taken to effect your removal. A warrant for your arrest will be issued if this office has not received verification of your departure
by the specified date. Failure to depart on or before the specified date may also subject you to a possible civil penalty of not less
than $1,000 and not more than $5,000, and render you ineligible for a period of 10 years for any further authorization for voluntary
departure or for relief under sections 240A, 245, 248, and 249 of the Immigration and Nationality Act.
If
Available
Printed Name/Title Signature of Official Verifying Identity
U.S. Departure Place
Method of Departure
Date
Comments
TrainAir Boat Other:
DHS Official Serving Form (Name and Title)
Date
