Ice Privacy Waiver Form

Ice Privacy Waiver Form
The linked form could be beneficial for certain business owners, employees, customers, family members or other acquaintances in the event of an ICE detention.
It’s a form shared with us by U.S. Rep. Katherine Clark’s office that would enable her office or any other Congressional or Senate office, or other designee, to communicate on behalf of a person in the event of a detainment.
Here’s how it works:
- Share this document with anyone to whom it might apply. Encourage them to complete it IN FULL, including date, witness, and original signatures.
- In Step 2 of the form, it is recommended that s/he checks “all”, granting permission to obtain all records. Otherwise, ICE will restrict what information they’ll share. If anything applies in her/his situation about protected records (asylum, TPS, etc.), s/he should also check those boxes in Step 2.
- If any part of the form is not complete or completed incorrectly, that can be used as a pretext not to respond. If an individual is working with someone to translate, they should have the translator review the form carefully.
- Once completed, the form should be given to a spouse, employer, or other trusted ally for safekeeping.
If the individual is detained, this form will enable their U.S. Congressperson, Senator, or others to advocate or inquire on that person’s behalf.
Again, to be clear: The form should be completed now, but it should only be shared in the event of a detention. Otherwise, it remains privately held by a trusted person.
In the event of a detention, the chamber can help facilitate a connection to one of our federal representatives.