法律訊問

Information About You

First Name:

 Middle Name:
 Last Name:
Other names used including maiden names:
Gender:
M 		F
Current Address in U.S.
Number & Street :
City:
 State:
 Zip:
Last Address Outside of U.S.
Number & Street :
City:
 State/Province:
 Postal:
 Country:

Home Phone:

Hours we can call:

Fax. Number:

Work Phone:

Hours we can call:

Cell Phone / Pager:

Social Security No.
 Citizenship:

Date & Place of Birth

Date of Birth (dd/mm/yyyy):
  

City or Town:

State or Province:

Country:

Passport Information

Passport Country:

Passport Number:

Expiry date (dd/mm/yyyy):
 

What type of immigration assistance are you seeking?

 

Family Information
Spouse:
In U.S.      Outside U.S.      Not Married
Spouse's First Name:

Spouse's Middle Name:

 Spouse's Last Name

Other names used (including maiden name):

Current Address (put "same" if you live together):

Date of Birth (dd/mm/yyyy)
 Place of Birth
 Social Security No.
Date of Marriage (dd/mm/yyyy)
 Place of Marriage:
 Alien "A" No.
Citizenship:
 Immigration Status:
 Expiry Date(dd/mm/yyyy):
Applying with you?
    
     
Children:
Number of children:
Child #1:      
Name:
 Gender:
 Date of Birth (dd/mm/yyyy)
 Country of Birth
Citizenship
 Applying /w you

 Immigration Status
 Expiry Date (dd/mm/yyyy)
Child #2:
Name:
 Gender:
 Date of Birth (dd/mm/yyyy)
 Country of Birth
Citizenship
 Applying /w you

 Immigration Status
 Expiry Date (dd/mm/yyyy)
Child #3:      
Name:
 Gender:
 Date of Birth (dd/mm/yyyy)
 Country of Birth
Citizenship
 Applying /w you

 Immigration Status
 Expiry Date (dd/mm/yyyy)
Child #4:      
Name:
 Gender:
 Date of Birth (dd/mm/yyyy)
 Country of Birth
Citizenship
 Applying /w you

 Immigration Status
 Expiry Date (dd/mm/yyyy)
Child #5:      
Name:
 Gender:
 Date of Birth (dd/mm/yyyy)
 Country of Birth
Citizenship
 Applying /w you

 Immigration Status
 Expiry Date (dd/mm/yyyy)
Child #6:      
Name:
 Gender:
 Date of Birth (dd/mm/yyyy)
 Country of Birth
Citizenship
 Applying /w you

 Immigration Status
 Expiry Date (dd/mm/yyyy)
Parents
 
Father's name
 Country of Birth
 Citizenship
 Immigration Status
 
Mother's name
 Country of Birth
 Citizenship
 Immigration Status
 
Father-in-law's name
 Country of Birth
 Citizenship
 Immigration Status
 
Mother-in-law's name
 Country of Birth
 Citizenship
 Immigration Status

Previous Marriages

Check here if not applicable  



Name
Date of
Marriage
Country of
Marriage

Kids?		 Reason for
Termination
of Marriage		 Date of
Termination
of Marriage		 Country of
Termination
of Marriage
Your's:
Spouse's:

 

IMMIGRATION HISTORY

Current Immigration Status:
 Date Status Expires:
 Alien ("A") Number:
Date of First Entry into U.S.:
 Last Entry into U.S.:
 I-94 Number:
Check every type of immigration status that you have ever held and provide the dates:
Immigration Status Date(s) Immigration Status Date(s)
B Visitor: E Trader/Investor:
F Student: H-1B Professional:
J Exchange Visitor: K Fiancee:
L Manager: O Outstanding Ability:
T/N Canadian Worker: Other:
Check each one that you or your spouse have ever applied for or been the beneficiary of:
Y(you) or
S(Spouse)
Date Filed
 Sponsor
 Attorney
 Result
Green Card
Immigrant petition
Labor certification
Asylum
Amnesty

Have you or your spouse ever had any immigration problems? In particular, have you or your spouse ever been under removal, deportation, or exclusion proceedings? Please describe in detail:

 

EMPLOYMENT HISTORY
Current Employer (or Employer Petitioning on Your Behalf)
Employer:
Address:
Job Title:     Salary:
Date of Hire: Are you related to your employer?
May we contact your employer?
If yes, whom may we contact:
Name
 Title
 Company
 Phone

 

Employment in Last Five Years (anywhere in the world)

Job Title Employer Country Duration
JOB QUALIFICATIONS

List the professional licenses or certifications you possess, from any state or country:

How many years of experience do you have in your position or field?

 

EDUCATIONAL BACKGROUND
Please list all your education anywhere in the world:

Level
School/Country
Degree & Major

Number of
Years
Graduate?
College/University:
College/University:
Other Schooling:

 

OTHER INFORMATION
Have you ever been arrested or convicted of a crime anywhere in the world (even if the conviction was expunged or removed from your record) or have you ever had any problems with the police?
If yes, please explain in detail:
Have you ever claimed to be a citizen of the United States or have you ever used another name
for immigration purposes or for any other reason?
If yes, please explain in Detail:
Have you ever been denied a visa to come to the United States?
If yes, when and what kind of visa:
During what years, if any, have you filed an Income Tax Return with the IRS?
If you ever had an Employment Authorization Card issued by the INS, give number(s) and validity dates:
Is there anything, not already covered in this form, that you feel we should know?

 

STATEMENT OF TRUTHFULNESS

"By pressing the Submit button below,
I certify that all of the information contained in this form is true
and correct to the best of my knowledge."



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