KNOW YOUR RIGHTS
You have the right to remain silent • You do not have to open the door • You have the right to an attorney
Family Name:
Date Prepared:
| Contact Person | Relationship | Phone | Email/Address |
|---|---|---|---|
| Primary Emergency Contact (Someone you trust completely) | |||
| Secondary Emergency Contact | |||
| Immigration Attorney | |||
| Name | Date of Birth | Immigration Status | A-Number (if applicable) |
|---|---|---|---|
Designated Temporary Guardian for Children:
Name:
Phone: Address:
Relationship:
Backup Guardian:
Name:
Phone: Address:
Children's School/Daycare Contacts:
| Child Name | School/Daycare | Phone | Contact Person |
|---|---|---|---|
| Document | Location | Who Has Access |
|---|---|---|
| Passports | ||
| Immigration Documents | ||
| Birth Certificates | ||
| Social Security Cards | ||
| Bank/Financial Info | ||
| Medical Records | ||
| Property Documents | ||
| Emergency Cash |
Bank Name:
Account Access: (who has access for emergencies)
Bill Payment Arrangements:
Emergency Funds Location:
| Organization | Services | Phone |
|---|---|---|
| Immigration Legal Services | ||
| Community Support Organization | ||
| Religious/Cultural Center | ||
| Legal Aid Hotline |
CARRY THIS WITH YOU
I wish to remain silent. I do not wish to answer your questions.
I do not consent to a search.
I wish to speak to a lawyer.
I do not wish to sign anything without speaking to a lawyer first.
Attorney: _________________ Phone: _________________
☐ Reviewed plan with all family members
☐ Discussed emergency scenarios with children (age-appropriate)
☐ Shared plan with designated guardians
☐ Provided copies to attorney and emergency contacts
☐ Set reminder to review plan every 6 months
Last Updated: _________________ Next Review: _________________
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