EOIR-62 Volunteer Waiver for Gratuitous Services

U.S. Department of Justice
Executive Office for Immigration Review

OMB#1125-XXXX
Volunteer Waiver for Gratuitous Services

Purpose: To enable the agency to accept gratuitous services from uncompensated volunteers who will not displace any federal
employee. This signed written waiver must be received in advance of services being rendered.

I, _________________________, AND/OR ______________________________________________,
(Name of Volunteer)
(Authorized Representative of Organization)
declare under penalty of perjury, that I am willing and able to provide gratuitous services to the Executive
Office for Immigration Review as described below:

___________________________________________________________________________________

DESCRIPTION OF GRATUITOUS SERVICES TO BE PERFORMED (for example, Friend of the Court services)

I acknowledge that neither I, nor my organization or law firm, are presently a party to the matters before the
Executive Office for Immigration Review for which these gratuitous services are being provided.
I hereby state that I am able and willing to provide these services without expectation of payment, and waive any
future pay claims against the Government for the services described above.
I understand that this waiver may be terminated by either myself or the Executive Office for
Immigration Review at any time.
Signed this _________________, by:
Date
_________________________________
Print Name

______________________________________
Signature

_________________________________
Name of Firm/Organization

______________________________________
EOIR and Bar Identification Number, if any

_________________________________
Street Address, Apt/Suite

______________________________________
Phone Number

_________________________________
City, State, Zip Code

______________________________________
Email Address

Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a valid OMB control number.
Every effort is made to create forms and instructions that are accurate, can be easily understood, and which impose the least possible burden on you to
provide information. The estimated average time to review and complete the form is 5 minutes. If you have comments regarding the accuracy of this
estimate, or suggestions for making this form simpler, you can write to the Executive Office for Immigration Review, Office of the General Counsel,
5107 Leesburg Pike, Suite 2600, Falls Church, Virginia 22041.
Privacy Act Statement: The collection of this information is authorized by 8 U.S.C. §§ 1158, 1229 and 8 C.F.R. §§ 1003, 1240, 1241. All information
provided in this form is voluntary. The information you provide will be used to maintain official records of volunteers of the EOIR for the purposes of
tort claims, injury compensation, and other volunteer claims allowed by law. While furnishing this information is voluntary, if this form is incomplete,
provision of services cannot be accepted.

Form EOIR-62
Rev. March 2022