• Sworn Declaration Form

  • Record of Sworn Statement

  • Date:*
     - -

  • I am a United States Immigration and Naturalization Service officer, and I am authorized by law to administer oaths and take testimony in conjunction with the execution of the United States Immigration and Naturalization statutes. I'd like to take your oath on the following:

  • You must first understand your rights before I can ask you any questions:

    • You have the right to remain silent at all times.
    • In court, or in any immigration or administrative procedure, everything you say can be used against you.
    • Before we ask you any questions, you have the right to consult with an attorney for guidance, and you have the right to have him present during questioning.
    • If you cannot afford an attorney, one will be appointed for you before you are questioned.
    • You have the right to cease answering questions at any point if you decide to answer them now without consulting a lawyer.
    • You also have the option of delaying your response until you consult with an attorney.
  • Would you like a lawyer or another individual to give you advice?*
  • Are you available to answer my inquiries right now?*
  • Should be Empty:
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