Source: https://www.ice.gov/webform/hsi-tip-form
Timestamp: 2019-04-20 06:55:33+00:00

Document:
U.S. Immigration and Customs Enforcement (ICE) investigates more than 400 violations of criminal law, ranging from child exploitation to transnational gangs. Use this form to report suspected criminal activity.
Be as specific and as detailed as possible. You are encouraged to provide any additional identifying details such as places of birth, countries of citizenship, and any numeric identifiers in the below narrative text box. The detailed information you provide will assist investigators as they look into reported violations.
We do not provide status updates for tip information provided. If you provide information, you can be assured that it will be promptly forwarded to the responsible office for follow up action as deemed appropriate.
Do NOT send the same information more than once, and do NOT file a duplicate report by calling the HSI Tip Line.
If you have additional businesses/individuals to report on, please complete another form after you submit this completed form. Thank you.
Authority: The collection of information that you provide in this web form is authorized by the following: 6 U.S.C. § 202; 8 U.S.C. § 1103; 8 U.S.C. § 1357, 8 U.S.C. § 1360; Title 18, United States Code; 19 U.S.C. § 1589a; 31 CFR Chapter X, 5 U.S.C. § 552a; 5 U.S.C. § 301; and 44 U.S.C. § 3101. Please also see the privacy policies for ICE's public website, available at www.ice.gov/site-policies.
Purpose: ICE may use the information you provide to initiate and/or support a law enforcement investigation. ICE may use your personal information, if provided, to contact you for additional details about your tip, or to arrange monetary payment, if applicable.
Agency Disclosure of Information: The information you provide may be shared internally within DHS for any appropriate official purpose. The information you provide may also be shared with federal, state, local, tribal, territorial, and foreign law enforcement agencies in order to refer reports of suspicious activity, tips, potential violations of law and other relevant information to those agencies with appropriate jurisdiction, authorities, and need-to-know concerning the matter(s) you report, or as otherwise required by law.
If you are a United States Citizen, lawful permanent resident, or are an individual whose records are covered by the Judicial Redress Act of 2015 (5 U.S.C. § 552a note), your information may be disclosed in accordance with the Privacy Act of 1974, 5 U.S.C. § 552a(b), including pursuant to the routine uses published in the DHS/ICE-016 FALCON Search and Analysis System of Records Notice (SORN), which can be viewed at https://www.dhs.gov/system-records-notices-sorns.
Disclosure: Providing your name or other personal information on this web form is voluntary. If you do not provide the requested information, ICE may not be able to take action on your tip. Anonymous tips may be reported to ICE via the toll-free HSI Tip Line, (866) 347-2423.
Public Reporting Burden: U.S. Immigration and Customs Enforcement is collecting this information as a part of its agency mission under the Department of Homeland Security. The estimated average time to review the instructions, search existing data sources, gather and maintain the data needed and completing and reviewing this collection of information is 10 minutes (0.166 hours) per response. An agency may not conduct or sponsor, and a person is not required to respond to, an information collection unless it displays a currently valid OMB Control Number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: Office of the Chief Information Officer, Forms Management Office, 801 I Street NW, Washington, DC 20536-5800, ATTN: PRA Officer. Do not return the completed form to this address.
The information I've provided on this form is correct to the best of my knowledge. I understand that providing false information could subject me to fine, imprisonment, or both. (Title 18, U.S.C. § 1001).

References: § 202
 § 1103
 § 1357
 § 1360
 § 1589
 § 552
 § 301
 § 3101
 § 552
 § 552
 § 1001