U.S. Department of Justice
Executive Office for Immigration Review
Change of Address/Contact Information Form
Immigration Court
Instructions: To complete this form, fill out all blanks below, including proof of service, which certifies that you will provide a copy of this form to the
Department of Homeland Security (DHS). After filling in the blanks and signing both the declaration and proof of service, you must submit the form
electronically, in person, or by mail. If submitting electronically, file in Respondent Portal at https://respondentaccess.eoir.justice.gov. Attorneys and fully
accredited representatives submitting this form electronically must file in Case Portal at https://portal.eoir.justice.gov
.
If submitting by mail, follow the
mailing instructions on Page 2. You must submit a separate copy of this form for each individual who has a case pending in immigration court and whom
the change of information affects.
You must file this form with the immigration court within five working days of the change to your contact information, or your receipt of a charging document (e.g., a
Notice to Appear) with incorrect contact information. The immigration court will send all official correspondence (e.g., notices, decisions) to the address you provide.
The immigration court will only make any change(s) to your contact information in EOIR’s records upon receipt of this form; t he immigration court will not change
your contact information based on different information on pleadings, motions, or other communications with the court.
If you fail to appear at any hearing before an immigration judge when notice of that hearing or other official correspondence was served on you or sent to the address
you provided, DHS may take you into custody. In addition, the immigration court may conduct your hearing in your absence and enter an order of removal,
deportation, or exclusion against you. If the court enters such an order, you may be ineligible for certain forms of relief from removal under the Immigration and
Nationality Act as follows:
If you are in removal proceedings: You will be subject to an order of removal for a period of ten years after the date of entry of the final order. You may also become
ineligible for voluntary departure, cancellation of removal, and adjustment of status or change of status.
If you are in deportation proceedings: You will be subject to an order of deportation for a period of five years after the date of the entry of the final order. You may
also become ineligible for voluntary departure, suspension of deportation or voluntary departure, and adjustment of status or change of status.
If you are in exclusion proceedings: Your application for admission to the United States may be considered withdrawn.
I declare under penalty of perjury, pursuant to 28 U.S.C. § 1746, that I am the person named above associated with the A-Number
listed above, and that the information contained in this form is true and correct to the best of my knowledge.
X
Signature
Date
PROOF OF SERVICE
I,
, provided a copy of this Change of Address Form on, , to the
(Name)
(date)
Office of the Principal Legal Advisor for DHS Immigration and Customs Enforcement-ICE at:
(Indicate if electronic/email service, or in-person or mail service (provide Number and Street, City, State, ZIP Code))
By signing, I agree to provide a copy of this Change of Address Form to the Office of the Principal Legal Advisor for DHS
Immigration and Customs Enforcement-ICE at the location I selected above. I understand that I can provide DHS with a copy either
electronically through the DHS eService portal (register at https://eserviceregistration.ice.gov), or by mail or personal delivery.
X
Signature