Border Encounter Processing Record Form
Use this form to record a border encounter, capture key individual and encounter details, and document the processing outcome.
Encounter Details
Encounter Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Encounter Time
*
Hour Minutes
AM
PM
AM/PM Option
Encounter Location / Port of Entry
*
Encounter Type
*
Pedestrian
Vehicle
Bus
Cargo
Other
Processing Status
*
Detained for Review
Referred to Secondary Inspection
Released
Transferred
Other
Individual Information
Full Name
*
First Name
Middle Name
Last Name
Date of Birth
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Nationality / Country of Citizenship
*
Please Select
United States
Mexico
Canada
Guatemala
Honduras
El Salvador
Other
Internal Reference Number / Travel Document Type
Disposition and Notes
Disposition / Referral Destination
*
Admitted
Referred to Secondary Inspection
Transferred to Another Agency
Released
Other
Officer / Processor Reference
*
Case Notes / Observations
Submit
Should be Empty: