Government memo, 2023

EFTA00173131¶

DEPARTMENT OF HOMELAND SECURITY¶

U.S. Immigration and Customs Enforcement¶

REQUEST FOR CONTINUED PRESENCE¶

Part A: Information on the Victim¶

1. Name:

(Last)¶

(First)¶

2. Date of Birth (mo., day, yr.)

3. Country of Birth

(Middle)¶

4. Country of Citizenship

5. Alias(es)

6. Gender (check one)

Slovakia¶

□ Male¶

⊗ Female¶

8. Passport Number

9. Alien Number (A#)

10. Country of Issuance

Slovakia¶

10. Expiration Date (mo., day, yr.)

11. Social Security Number

Part B: Requesting Agency Information¶

*Note: This information must be completed in order to receive consideration.¶

1. Lead Case Agent:

(First, Last)¶

2. Daytime telephone number

(include area code)¶

3. Fax number

Ext. ___¶

2. Case Agent where the Victim resides (if the Victim resides in a jurisdiction other than that of the Lead Case Agent):

(First, Last)¶

2. Daytime telephone number

(include area code)¶

3. Fax number

Supplemental Information:¶

Requesting Agency: Federal Bureau of Investigation¶

Group Supervisor’s name (First, Last)¶

Daytime telephone number (including area code)¶

Fax number ___¶

Victim-Witness Specialist’s/Coordinator’s name (First, Last)¶

Daytime telephone number (including area code)¶

Fax number ___¶

Request for Continued Presence FOR OFFICIAL USE ONLY / LAW ENFORCEMENT SENSITIVE¶

ICE Form 73-031 (4/11)¶

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EFTA00173132¶

Part C: Case Information¶

*Note: Please complete all information below.¶

1. Is the Victim currently in the United States? Yes No

2. The Victim’s current immigration status: In the U.S. on an E-2 Visa

3. Is the Victim requesting Continued Presence based upon a pending civil action under 18 U.S.C. § 1595?

☐ Yes ☒ No¶

If yes, provide details of where and when the civil action was filed, and the status of the civil action.¶

4. Has the Victim ever been deported/presently under deportation proceedings? □ Yes ⊗ No (if yes, where and when) City, State: ___

5. When did the Victim enter the United States? 1st Entry 09/01/2023

6. Through which Port of Entry did the Victim enter the United States? New York, New York

7. How did the Victim enter the United States? Flight

Part D: Specific Information Pertaining to the Victim¶

• Please answer each question as completely as possible (Attach additional sheet(s), if necessary.)

1. Significance and value of the Victim to this case: (Please provide a brief explanation of how the Victim meets the definition of “severe form of trafficking” under section 103(8), Victims of Trafficking and Violence Protection Act of 2000, Pub. L. No. 106-386.)

See attached sheet.¶

2. The Victim’s criminal involvement in this or any other case: (Please attach or describe criminal and/or arrest record listing ALL criminal convictions.)

No criminal convictions.¶

3. Risk the Victim presents to public safety and/or national security (i.e., has the alien ever engaged in a terrorist act, supported terrorist activities, or is a member of a known terrorist group? If so, explain.) List and explain proposed security precautions if necessary: (Attach copy of risk assessment report.)

No risk to public safety or national security¶

4. Financial responsibility for the Victim: (Please explain manner in which the Victim’s living expenses will be met.)

is requesting employment authorization to work in the United States.¶

5. Acquaintance/Relatives in the United States: (Please include name(s), relationship, and current location, i.e., city and state; attach additional sheet(s), if necessary.)

No relatives live in the United States.¶

Request for Continued Presence FOR OFFICIAL USE ONLY / LAW ENFORCEMENT SENSITIVE¶

ICE Form 73-031 (4/11)¶

Page 2 of 4¶

EFTA00173133¶

6. Is employment authorization requested? ☒ Yes □ No

(If yes, please attach completed U.S. Citizenship and Immigration Services Forms I-765, Application for Employment Authorization, and I-102, Application for Replacement/Initial Nonimmigrant Arrival/Departure Document.)¶

Note: Information contained in question # 7 is not required for a victim to receive Continued Presence; however, this information is required for a victim to be certified to receive benefits from the Department of Health and Human Services (HHS), Office of Refugee Resettlement (ORR). A response to this question will assist HHS in ensuring the fast and efficient delivery of services to the Victim. Victims who have not attained 18 years of age do not need to be certified to receive benefits from HHS.¶

7. Is the Victim willing to assist in every reasonable way in the investigation and prosecution of a severe form of trafficking in persons? The term “investigation and prosecution” includes the: 1) identification of a person or persons who have committed severe forms of trafficking in persons; 2) location and apprehension of such persons; and 3) testimony at proceedings against such persons. Yes No

Part E: Location where the Victim will reside (City and state are required at a minimum.)¶

Street Address¶

City	New York	State	NY

*Initial requests are approved for a period of time determined on a case-by-case basis. ALL extensions for Continued Presence must be submitted to the ICE HSI Headquarters Law Enforcement Parole Unit (LEPU). Any change in status is to be reported to the requesting agency headquarters, which in turn will notify LEPU. The requesting agency will also notify LEPU immediately if the alien departs the United States.¶

Part F: Certification of Reporting Requirements¶

As the requesting agency representative, I understand that, should this Continued Presence be granted, it is MY responsibility to follow all of the policies and procedures established by LEPU, including quarterly reporting, reporting changes in the Victim’s status (i.e., departure or change in status), and requesting applicable extensions 30 days prior to the expiration of approved Continued Presence.¶

(Lead Group Supervisor’s Signature)¶

(Print Name and Title)¶

If the Victim resides outside the geographic area of the lead Case Agent, a monitoring agent must be designated in the appropriate jurisdiction.¶

(Monitoring Group Supervisor’s Signature)¶

(Print Name and Title)¶

(Monitoring Case Agent’s Signature)¶

(Print Name and Title)¶

(Date)¶

Request for Continued Presence FOR OFFICIAL USE ONLY / LAW ENFORCEMENT SENSITIVE¶

ICE Form 73-031 (4/11)¶

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EFTA00173134¶

Privacy Act Statement¶

Authority: 22 U.S.C. §§ 7102(8) and 7105(c)(3) authorize ICE to collect the information requested on this form.¶

Purpose(s): The information collected on this form will be used by ICE to: 1) clearly identify the individual for whom Continued Presence is being requested; 2) review and determine the eligibility of the individual to receive Continued Presence and remain in the United States; 3) grant or deny the request for Continued Presence; 4) identify and hold accountable the requesting law enforcement officer/agent and their agency to comply with ICE’s policies and procedures for administering the Continued Presence; 5) coordinate the administration of benefits available to the individual (if eligible); and 6) properly maintain a record of all requests for Continued Presence as well as provide oversight, tracking and reporting on Continued Presence activity throughout the duration of the authorized Continued Presence.¶

Routine Use(s): The information collected on this form may be shared with a criminal, civil, or regulatory law enforcement authority (whether Federal, State, local, territorial, tribal, international or foreign) where the information is necessary for collaboration, coordination and de-confliction of investigative matters. The information may also be disclosed as generally permitted under 5 U.S.C. § 552a(b) pursuant to the routine uses published in the Department of Homeland Security system of records notice, DHS/ICE-011 Immigration and Enforcement Operational Records.¶

Disclosure: The disclosure of the information on this form is voluntary; however, failure to provide the information may result in the delay or ultimate denial of the request for Continued Presence.¶

Request for Continued Presence FOR OFFICIAL USE ONLY / LAW ENFORCEMENT SENSITIVE¶

ICE Form 73-031 (4/11)¶

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