Removal Proceedings Background Information Form
Full Name
Alien Number (A#)
Date of Birth
Country of Birth
Current Address
Phone Number
Email Address
Type of Removal Proceedings
Deportation
Exclusion
Removal
Other
Immigration Court / Hearing Location
Next Hearing Date
Immigration Judge
Date and Manner of Entry to the U.S.
Status at Entry
Current Immigration Status
Family Members in the U.S.
Relief or Protection Sought
Additional Background or Notes