Form I-395 at a glance
What it is: Affidavit in Lieu of Lost Receipt of United States ICE for Collateral Accepted as Security, of the U.S. Immigration and Customs Enforcement.
Who signs: The obligor signs in ink on the Signature line and enters the Obligor Taxpayer Identification Number (Social Security Number).
The surety on an immigration bond executed in behalf of the alien.
ICE collects this information to permit an individual or company to sign a notarized affidavit when the original Receipt of Immigration Officer-United States Bonds, Notes or Cash (ICE Form I-305) is lost or missing.
A filled-in Form I-395 example: a surety files for a lost bond receipt
How to fill out Form I-395, box by box
State of and County of
Enter the State and the County.
The bonded alien
Enter the Bonded Alien A Number if known, then the Date and Place of Birth and the Receipt Number.
Obligor's name and where you reside
Enter the Obligor's Name, then the Number, Street, City, State and Zip Code where you reside.
The immigration bond and its collateral
Enter the Alien's Name, the Office where bond was posted and the Date bond was posted.
Enter the Amount of Bond for the certain securities deposited with the Immigration and Customs Enforcement as collateral security under such bond.
Reason for loss of original I-305
Enter the Reason for loss of original I-305: the receipt issued on the same day for such collateral security has been lost.
Signature and Subscribed and sworn to before me
Subscribed and sworn to before me At: enter the Location and On: the Date.
The NOTARY PUBLIC signs in ink on the Signature line and enters MY COMMISSION EXPIRES ON.
More rules for Form I-395
The obligor will be unable to reclaim the principal amount of the immigration bond unless this form or the original ICE Form I-305 is provided to ICE.
Common questions about Form I-395
Where do I file it?
This affidavit will not be effective unless it is properly notarized, and until the original form is received by the Bonds Section at Financial Operations - Burlington, U.S. Immigration and Customs Enforcement, P.O. Box 5000, Williston, VT 05495, its validity confirmed, and it is entered into an ICE database. If this affidavit is invalid, the Bonds Section will return it with a brief explanation of why it is not acceptable. By signing you promise that if the said receipt is located, you will see that it is surrendered to the Immigration and Customs Enforcement, and that you will save the government of the United States harmless from any claim, loss or liability whatsoever which may or might arise by reason of the surrender to you of the said collateral security without your producing the receipt issued therefore.
Sources
[1] ICE Form I-395 (9/19), Affidavit in Lieu of Lost Receipt of United States ICE for Collateral Accepted as Security, U.S. Immigration and Customs Enforcement (the Official source link on this page).
