Affidavit in Lieu of Lost Receipt of United States ICE for Collateral Accepted As Security

OMB 1653-0045

The data requested in this collection is used by ICE to ensure that the person or company posting the bond has the ability to complete an affidavit when the Receipt of Immigration Officer-United States Bonds, Notes, or Cash, accepted as security on an Immigration bond is lost or missing.

The latest form for Affidavit in Lieu of Lost Receipt of United States ICE for Collateral Accepted As Security expires 2022-09-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form I-395 Affidavit in Lieu of Lost Receipt of United States ICE for Collateral Accepted As Security Form and Instruction
1653-0045_Supporting Statement A 4_29_2019.docx Supporting Statement A
2019-08614.pdf Supplementary Document
2019-03547.pdf Supplementary Document
BMIS SORN.docx Supplementary Document
BMIS-Web PIA.pdf Supplementary Document
8 U.S.C. 1103.doc Supplementary Document
Affidavit in Lieu of Lost Receipt of United States ICE for Collateral Accepted As Security Form and Instruction

All Historical Document Collections

201808-1653-006 Approved without change	Extension without change of a currently approved collection	2019-04-30
201512-1653-003 Approved without change	Extension without change of a currently approved collection	2016-03-31
201211-1653-003 Approved with change	Extension without change of a currently approved collection	2013-01-29
200911-1653-001 Approved without change	Existing collection in use without an OMB Control Number	2009-11-17
200904-1653-003 Withdrawn	New collection (Request for a new OMB Control Number)	2009-06-29