Eoir - Stipulated Request For Removal Order And Waiver Of Hearing

UNITED STATES DEPART:MENT OF JUSTICE EXECUTIVE OFFICE FOR IMMIGRATION REVIEW OFFICE OF THE IMMIGRATION JUDGE

{ {

INTBEMATTER OF:

{ {

IN DEMOVAL PROCEEDINGS

nLENO: A__________

RESPONDENT STIPULATED REQUEST FOR DEMOVAL ORDER. AND W AIVEll OF HEAlUNG

I • RespondeD! herein make tile following requests, statements, admi.ssions,and stipulations: I have received a copy of the Notice to Appeal (NTA) dated , and my full, true and correct name is as indicated therein. See attached NTA. I have also received. a legal aid list. I (have/do not have) an attomey who will represent me in this maner. See

1.

attached Porm :COIR.-28.

2.

I request that my deportation proceedings be conducted completely on a. written record, . without a hearing. I waive all my rights and advisals contained in 8 C.F.R. §§ 240.10 and 240.11. including my right to have a beuing. to be advised by the Immigration Judge of any apparent eligibility of relief from deportation, to present witnesses and evidence on my behalf, aDd to require the govemment to prove my deportability.

3.

I admit all the allegations contained in the NTA, and co~e~that I am deportable

4.

I agree that I am not eligible, or if eligible, I waive my right to apply for relief from deportation. I am not seeking voluntary departure, asylum, adjustment of status, registry. de novo rev;ew of a termination of conditional resident staDls. de novo review of a denial or revocation. of temporary protected. status, C8.11CCllation of removal. or any other possible relief UD.<1er the Immigration and Nationality AI::t.

S.

I consent to the introduction of this .. Stipulated Request" as an exhibit to rfu!-recorc.i"of

6.

I desigcate_ _ _ _ _ _ _ _ _,as my country of choice for deponation.

as charged.

proceedings.

S

4

(

JSMca• •

4tll:;:q;: ,

,

:;:WW;:W,Z41.,oil$.

ex

d

I will accept a written order for Q:l.y removal to the above country as a final disposition of these Removal proceedings, and I waive appeal of the written order for my Removal from the United.

7.

.

s~~.

I understand that by accepting an order of Removal. I give up my right to apply for any relief for which I mish1 have been ellg~le. I understand that I (amlam not) a per:manent resident immigrant and tbat accepting an oIder of Removal rerminates my permanent residem status. I .

8.

also understand rbat I cannot retUrn to tbe United States legally for a period of five (5) years if found inadmissible under section 212; a period of ten (10) years if found deportable under section 237; a period of twenty (20) years after having been previ~usly excluded, dcporc.ed, or removed and found inadmissible under section 212, or deportable under section 237; or at any time because I have been found ina!lm.issible or excludable under 'section 212, or deportable under section 237 of the Act, and have been convicted of a crime designated as an aggravated felony.

In the event that my Removal proceedings are scheduled for a hearing, I waive any right to notice of such, a hearing. Addmottally. I waive my right to be present in person and, I also waive the presence of my attorney. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

9.

L

t or my attorney (if any), have read, (or have read to me in a language I understand), this entire "Stipulated Request-. I twly understand its consequences. I can. uneqUivocally state that 1 have subI¢tted this .. Stipulated Request" voluntarily, knowingly and intelligently .

10.

.

r certify that all the information I have give:D in the

II

Stipulated Request" is true and correct.

(Signature ot respondent)

(Date)

(Printed name of respondent)

(Signaf:ure of attomey, if any)

(Date)

(Printed name of attorney, if any)

Deputy District Counsel Immi~ation and Naturalization Service

(Date)

U

4

L,CCZi

ti