PAROLE WORKSHEET FOR MINOR BASED ON THE FLORES SETTLEMENT AGREEMENT Minor’s Name /A#: ____________________________________________________________ DOB: _______________ Name of Accompanying Parent /A#: __________________________________________ DOB: ________________ Facility Name and Location: ______________________________________________________________________ This worksheet must be utilized when considering minors for parole from custody. Pursuant to the June 27, 2017, order in Flores v. Sessions, No. 85-4544 (C.D. Cal. filed July 11, 1985), ICE is required to individually assess whether a minor, who is in expedited removal proceedings under § 235(b) of the Immigration and Nationality Act or has a final expedited removal order, is eligible for parole pursuant to the standard in Immigration and Nationality Act Section 212(d)(5)(A) and 8 C.F.R. § 212(d)(5). • Has an Urgent Humanitarian Reason Been Established? Yes No • Has a Significant Public Benefit Been Established? Yes No If yes, explain the basis for the conclusion (e.g., medical or law enforcement reasons): _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ SECURITY RISK FACTORS • Is there any reason to believe that the minor poses a danger to the community (prior arrests, convictions, gang associations) or U.S. national security? Yes No If yes, explain (including any mitigating evidence such as proof of rehabilitation) and why it does or does not justify continued detention: _ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ RISK OF FLIGHT FACTORS • Does the minor have a valid, government-issued identity document(s)? Yes No If yes, list the document(s) and attach a copy to the form: _______________________________________________________ • When and how did the minor last enter the United States? Explain: _____________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ • Does the minor (and/or parent) have a prior immigration history (to include a record of nonappearance at court hearings or DHS appointments)? Yes No If yes, explain:_________________________________________________________________________________________________ _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ Page 1 • Has a verifiable address been identified where the minor will reside if released? Yes No If yes, list the address and telephone number and method of verification: ___________________________________________________________________________________________ ____________________________________________________________________________________________________ • If parole to a sponsor other than the accompanying parent is being considered, does the sponsor have a valid governmentissued identity document? Yes No If yes, list the document and attach a copy:__________________________________ _______________________________ • Does the minor have ties to the community (e.g., relatives, organizations)? Yes No If yes, include the relationship and immigration status of any identified relative(s), organizations, etc.: ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ADDITIONAL FACTORS • Are there any additional factors relevant to whether the minor should be released? Yes No Please explain: _______________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ RECOMMENDATION AND DECISION • Officer / Preparer Recommendation: (Name and Title) Grant Parole (Signature) Deny Parole (Date of Recommendation) Explain the basis for the recommendation: _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ • Deciding Officials Decision: (Name and Title) Grant Parole (Signature) Management Comment(s), if any: Deny Parole (Date of Decision) ___ ___ __________ Page 2