Attachment 6 - Remove Participant Form 2025-08-15.pdf
PDF 629 KB Posted
- Attached to
- Intensive Supervision Appearance Program V Solicitation Federal contract opportunity
- Solicitation number
- 70CDCR25R00000018
- Issued by
- Immigration and Customs Enforcement
About this file
This document is a Notice to Terminate ATD (Alternatives to Detention) Participation form used by immigration enforcement agencies. The two-page form provides a standardized template for officially documenting the termination of an individual's participation in an ATD program, with multiple checkbox options for different termination scenarios including departure verification, program violations, relief/benefit grants, arrests, and other administrative closure reasons. The form requires completion of fields such as ATD Field/Sub Office, ATD Officer, Contract Program Manager, participant's full name, A-Number, and termination date/time, and instructs the user to submit both pages to the contractor office with details about the written notification date and method of notification (fax, telephone, in-person, email).
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Text version
Attachment 6
NOTICE TO TERMINATE ATD PARTICIPATION
ATD Field/Sub Office: ATD Officer:
TO: (Name of Contract Program Manager) Site Location:
This official notice serves to immediately terminate the following participant from ATD
Participant’s Full Name: A-Number: Termination Date and Time:
A. Departure Verified (Final Order of Removal—close in EARM within 72 hours of departure)
B. Relief/Benefit Granted ( Cancellation of Removal Adjustment of Status Asylum
Admission)
C. Pre-Order Program Absconder
D. Post-Order Program Absconder
E. Pre-Order Program Violator
F. Post-Order Program Violator
G. No Longer Required to Participate (check one)
Change of Venue Administrative Closure Transfer to Non-Detained Case Transferred to Another Field Office Proceedings Terminated Withholding of Removal Temporary Protected Status Deferred Action (e.g. DACA) Prosecutorial Discretion Convention Against Torture/Deferral of Removal Stay of Removal Granted (I-246) Unable to Remove in the Foreseeable Future
Other
H. Arrested by ICE for Removal (Final Order—Active Participant)
I. Pending Departure Verification (Final Order of Removal or Voluntary Departure)
J. Arrested by other Law Enforcement Agency
K. Medical or deceased
L. Departure Verified (Voluntary Departure Order – close in EARM within 72 hours of departure)
M. Departed the United States while in proceedings
N. Appeal Program Violator
O. Appeal Program Absconder
Comments:
Written Notification Date: Notification Method: (via FAX, telephone, in-person, email.)
Submit all two (2) pages to contractor office.
File details come from the government source that posted it. Updated .