UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA UNITED STATES OF AMERICA, v. PLAINTIFF CASE NUMBER: DEFENDANT. DECLARATION RE PASSPORT AND OTHER TRAVEL DOCUMENTS I, (Defendant/Material Witness) , declare that I have never been issued any passport or other travel document by any country. I will not apply for a passport or other travel document during the pendency of this case. I have been issued a passport or other travel document(s). I will surrender my passport and all other travel document(s) issued to me to the U.S. Pretrial Services Agency by the deadline imposed. I will not apply for a passport or other travel document during the pendency of this case. I am unable to locate my passport(s) or other travel document(s). If I locate any passport or other travel document issued to me, I will immediately surrender it to the U.S. Pretrial Services Agency. I will not apply for a passport or other travel document during the pendency of this case. My passport and all other travel documents issued to me are in the possession of federal authorities. If any such document is returned to me during the pendency of this case, I will immediately surrender it to the U.S. Pretrial Services Agency. I will not apply for a passport or other travel document during the pendency of this case. I declare under penalty of perjury that the foregoing is true and correct. Executed this at day of (City and State) Signature of Defendant/Material Witness If the declarant is not an English speaker, include the following: , am fluent in written and spoken English and I, languages. I accurately translated this form from English into to declarant on this date. Date: CR-37 (05/15) , 20 Interpreter DECLARATION RE PASSPORT AND OTHER TRAVEL DOCUMENTS American LegalNet, Inc. www.FormsWorkFlow.com