INSTRUCTIONS 1. May I file this application? - You may file this application if you have been ordered deported or removed from the United States and you wish to obtain a stay of deportation or removal under the provisions of 8 CFR 241.6. 2. Where should I submit the application? - Submit this application to the local office of the Immigration and Naturalization Service (INS) having jurisdiction over the place you are currently located. If you are unsure of the address of that office, you may either check the listing in your local telephone book or call 1-800-375-5283 and receive the address based on your telephonic area code. 3. What additional documents or evidence should I submit with this application? - PASSPORT. You must submit a passport valid for at least 60 days beyond the expiration of the requested stay with this application, or explain why this is not possible to do so. ADDITIONAL EVIDENCE. You may submit any additional evidence in support of your application which you want considered by INS. 6. Under what authority is the information requested? The authority to prescribe this form is contained in 8 U.S.C. 1203(a). Submission of the information requested on this form is voluntary. The solicited information will be used by INS principally to determine whether the applicant is eligible for a stay of deportation or removal under the provisions of 8 CFR 241.6. The information may also, as a matter of routine, be used by or disclosed to other federal, state, local and foreign law enforcement and regulatory agencies. All applicants arc subject to a check of criminal information databases in order to determine eligibility. 7. What can happen if I submit false information? - All statements made in response to questions in this application are declared to be true and correct and under penalty of perjury. Title 18, United States Code, Section 1546, provides, in part: ...Whoever knowingly makes under oath, or as permitted under penalty of perjury under section 1746 of Title 28, United States Code, knowingly subscribes as true, any false statement with respect to a material fact in any application, affidavit, or other document required by the immigration laws or regulations prescribed thereunder, or knowingly presents any such application, affidavit, or other document containing any such false statement shall be fined in accordance with this title or imprisoned not more than five years, or both. 4. If the application is denied, may I file an appeal from that decision? - No. The denial of an application for a stay of deportation or removal may not be appealed. 5. What fee should I submit with the application? - A fee of $155.00 must be paid for filing this application. It cannot be refunded regardless of the action taken on the application. DO NOT MAIL CASH. ALL FEES MUST BE SUBMITTED IN THE EXACT AMOUNT. Payment by check or money order must be drawn on a bank or other institution located in the United States and be payable in United States currency. If the applicant resides in Guam, check or money order must be payable to the ''Treasurer, Guam.'' If the applicant resides in the Virgin Islands, check or money order must be payable to the ''Commissioner of Finance, Virgin Islands.'' All other applicants must make the check or money order payable to the "Immigration and Naturalization Service.'' When the check is drawn on the account of a person other than the applicant, the name of the applicant must be entered on the face of the check. If the application is submitted from outside the United States, remittance may be made by bank international money order of foreign draft drawn on a financial institution in the United States and payable to the Immigration and Naturalization Service in United States currency. Personal checks are accepted subject to collectibility. An uncollectible check will render the application and any document issued pursuant thereto invalid. A charge of $30.00 will be imposed if a check in payment of a fee is not honored by the bank on which it is drawn. The knowing placement of false information on the application may subject you, or the preparer of this application, to criminal penalties under 18 U.S.C., and you and the preparer to civil penalties under section 274C of the INA, 8 U.S.C. 1324c. Paperwork Reduction Act Notice. Under the paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. We try to create forms and instructions that are easily understood and which impose the least possible burden on you to provide us with information. Often this is difficult because some immigration laws are very complex. The estimated average time to complete and file this application is 30 minutes. If you have comments regarding the accuracy of this estimate or suggestions for making this form simpler, you can write to the Immigration and Naturalization Service, HQPDI, 425 I Street N.W., Room 4034, Washington, DC 20536; OMB No. 1115-0055. Do not mail your completed application to this address. NOTICE Neither the filing of this application, nor the failure to receive a notice of decision thereon shall relieve or excuse the applicant from presenting himself or herself for deportation or removal at the time and place designated for deportation or removal. Form I-246 (Rev. 09/19/00) Y American LegalNet, Inc. www.USCourtForms.com OMB APPROVAL NO. 1115-0055 U.S. Department of Justice Immigration and Naturalization Service Application for Stay of Deportation or Removal Fee Stamp SUBMIT IN DUPLICATE Read instructions on reverse before filling out application File No. Date 1. Name (Family Name in CAPITAL letters, First, Middle) 2. Present Address (Apt. No.) (Number and Street) (Town or City) (State) (Zip Code) 3. Country of Citizenship 4. Date to which passport is valid (Attach passport) 5. Country to which deportation or removal has been ordered 6. Date to which stay of deportation or removal is requested 7. Reasons for requesting stay of deportation or removal 8. I certify that the statements I have made in this application are true and correct to the best of my knowledge and belief. (Signature) (Location) (Date) 9. Signature of person preparing form, if other than applicant. I declare that this document was prepared by me at the request of the applicant and is based on all information of which I have knowledge. Failure by a preparer to complete this block may result in criminal prosecution and, upon conviction, a fine or imprisonment. (Signature) (Printed Name) (Date) APPLICANT: DO NOT WRITE BELOW THIS LINE Stay Denied Granted at (Date) (Place Where Granted) By (Signature) (Title) (Date) Form I-246 (Rev. 09/19/00)Y American LegalNet, Inc. www.USCourtForms.com