Professional Documents
Culture Documents
Application For A Stay of Deportation or Removal: U.S. Immigration and Customs Enforcement
Application For A Stay of Deportation or Removal: U.S. Immigration and Customs Enforcement
Fee/Date Stamp
Other:
Other:
Decision made by
(Printed Name/Title)
Office:
File Number
Date
Last Name
First Name
Middle Name
Apartment Number:
Town/City:
State:
Telephone Number:
Zip Code:
Expiration Date:
Brief
Other (specify):
I certify under penalty of perjury that the information provided and contained herein is true and correct to the best of my
knowledge and belief:
(Printed Name)
(Signature)
(Telephone Number)
(Signature)
(Street Address)
(City)
(State)
(Zip Code)