Respondent'S Written Pleading Form - United States Department Of Justice


United States Department of Justice
Executive Office for Immigration Review
Immigration Court
Boston, MA 02203
In the Matter of:
File No: A -
In Removal Proceedings
On behalf of my client, I make the following representations:
The respondent concedes proper service of the Notice to Appear, dated _____________.
I have explained to the respondent(through an interpreter, if necessary):
a. the rights set forth in 8 C.F.R. § 1240.10(a);
b. the consequences of failing to appear in court as set forth in INA § 240(b)(5);
c. the limitation on discretionary relief for failure to appear set forth in INA § 240(b)(7);
d. the consequences of knowingly filing or making a frivolous application as set forth in
INA § 240(d)(6);
e. the requirement to notify the court within five days of any change of address or
number, using Form EOIR-33/IC pursuant to 8 C.F.R. § 1003.15(d).
The respondent concedes the following allegation(s)__________________, and denies
the following allegation(s)________________.
The respondent concedes the following charge(s) of removability__________________,
and denies the following charge(s) of removability________________.
In the event of removal, the respondent:
names_________________as the country to which removal should be
declines to designate a country of removal.
The respondent will be applying for the following forms of relief from removal:
Termination of Proceedings
Withholding of Removal(Restriction on Removal)
Adjustment of Status
Cancellation of Removal pursuant to INA § ______________
Waiver of Inadmissibility pursuant to INA § ______________
Voluntary Departure
If the relief from removal requires an application, the respondent will file the application(other than
asylum), no later than fifteen (15) days before the date of the individual calendar hearing, unless otherwise
directed by the court. The respondent acknowledges that, if the application(s) are not timely filed, the
application(s) will be deemed waived and abandoned under 8 C.F.R. § 1003.31(c).
If the respondent is filing a defensive asylum application, the asylum application will be
filed in open court at the next master calendar hearing.
If background and security investigations are required, the respondent has received DHS
biometrics instructions and will timely comply with the instructions. I have explained the instructions to
the respondent(through an interpreter, if necessary), that, under 8 C.F.R. §
1003.47(d), failure to provide biometrics or other biographical information within the
time allowed will constitute abandonment of the application unless the respondent demonstrates that such
failure was the result of good cause.


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