U.S. Department of Justice
Immigration and Naturalization Service
Application to Pay Off or
Discharge Alien Crewman
(To be filed in triplicate. See Instructions on reverse)
Date of Arrival:
Arrival Manifest Filed at
(Port):
Carrier:
I.
Name in Full
Action by INS
Nationality and
Given Name and
Passport Number
Middle Initial
Family Name
(If additional space is required, attached list in triplicate)
Reason for request:
IV.
Arrangements for departure from the U.S. of the listed crewmen are (date and port of departure, air carrier and
flight number or vessel).
Mailing Address of Carrier:
Signature
Title
FOR GOVERNMENT USE ONLY
Date:
Copy:
Delivered
Application:
Mailed
Granted Denied
Signature:
Date:
Office:
Title:
Signature and Title:
OMB No. 1115-0073
Form I-408 (Rev. 05/17/00)Y
I hereby request authorization to the alien crewmen listed below.
PAY OFF/DISCHARGE
II.
III.
NOTICE
SECTION 256 OF THE IMMIGRATION AND NATIONALITY ACT (8 USC 1286)
It shall be unlawful for any person, including the owner, agent, consignee, charterer, master or
commanding officer vessel or aircraft, to pay off or discharge an alien crewman, except an alien
lawfully admitted for permanent residence, employed on board a vessel or aircraft arriving in
the United States without first having obtained the consent of the Attorney General. If it shall
appear to the satisfaction of the Attorney General that any alien crewman has been paid off or
discharged in the United States in violation of the provisions of this section, such owner, agent,
consignee, charterer, master, commanding officer or other person, shall pay to the
Commissioner the sum of $3,000 for each such violation. No vessel or aircraft shall be granted
clearance pending the determination of the question of the liability to the payment of such sums
or while such sums remain unpaid, except that clearance may be granted prior to the
determination of such question of the liability to the payment of such sums or while such sums
remain unpaid, except that clearance may be granted prior to the determination of such question
upon the deposit of an amount sufficient to cover such sums, or of a bond approved by the
Commissioner with sufficient surety to secure the payment thereof. Such fine may, in the
discretion of the Attorney General, be mitigated to not less than $1,500 for each violation, upon
such terms as he shall think proper.
REPORTING BURDEN
PUBLIC REPORTING BURDEN.
Reporting burden for this collection of information is
estimated to average 15 minutes per response. If you have comments regarding the accurancy
of this estimate, or suggestions for making this form simpler, you can write to the U.S.
Department of Justice, Immigration and Naturalization Service, HQPDI, 425 I Street N.W.,
Room 4034, Washington, DC 20536; OMB No. 1115-0073.
DO NOT MAIL YOUR
COMPLETED APPLICATION TO THIS ADDRESS.
INSTRUCTIONS
Form I-408 (Rev. 05/17/00)Y Page 2
4.
Disposition:
The original and one copy of the granted application will be returned to the
applicant. The copy must be submitted with the departure manifest. One copy of the
application will be retained by the Immigration and Naturalization Service with the arrival
manifest.
1.
Filing:
The application must be completed in triplicate and delivered or mailed to the
nearest office of the Immigration and Naturalization Service.
2.
Execution:
The signature and title of either the owner, agent, consignee, charterer, master
or commanding officer of the vessel or aircraft seeking authorization to pay off or discharge
crewmen must be included on the application.
3.
General:
Inadequate or incomplete data required in items III, Reason for request, and IV,
Arrangements for departure, may result in denial of the application.