Client Information
Date: [Insert Date]
Full Name: [Insert Full Legal Name]
Other Names (if applicable): [Insert Alias or Previous Names]
Date of Birth: [MM/DD/YYYY]
Place of Birth: [City, State, Country]
Nationality: [Insert Current Nationality]
Current Address:
[Street Address]
[City, State, ZIP Code]
Phone Number(s): [Insert Contact Numbers]
Email Address: [Insert Email Address]
Immigration History
1. Current Immigration Status (if any):
[Insert Current Visa or Immigration Status, e.g., “B-2 Visitor Visa,” “Lawful Permanent Resident”]
2. Date of Last Entry to the United States:
[MM/DD/YYYY]
3. Port of Entry:
[Insert Location of Entry]
4. Have you ever applied for a U.S. visa or immigration benefit?
☐ Yes ☐ No
If yes, provide details (application type, date, outcome):
[Provide Details]
5. Have you ever been denied entry to the U.S. or had a visa application denied?
☐ Yes ☐ No
If yes, provide details:
[Provide Details]
Family Information
1. Are you currently married?
☐ Yes ☐ No
If yes, provide spouse’s information:
Full Name: [Insert Full Name]
Date of Birth: [Insert DOB]
Nationality: [Insert Nationality]
Current Immigration Status (if any): [Insert Status]
2. Do you have children?
☐ Yes ☐ No
If yes, list their details below:
| Full Name | Date of Birth | Nationality | Current Location |
|---|---|---|---|
| [Child 1 Name] | [DOB] | [Nationality] | [Location] |
| [Child 2 Name] | [DOB] | [Nationality] | [Location] |
Employment and Education
1. Are you currently employed?
☐ Yes ☐ No
If yes, provide employer details:
Employer Name: [Insert Name]
Position: [Insert Job Title]
Location: [Insert Address]
2. Highest Level of Education Achieved:
[Insert Degree or Certification]
Field of Study: [Insert Field]
Legal and Criminal History
1. Have you ever been arrested, charged, or convicted of a crime in any country?
☐ Yes ☐ No
If yes, provide details:
[Provide Case Details]
2. Have you ever been placed in removal or deportation proceedings in the United States?
☐ Yes ☐ No
If yes, provide details:
[Provide Case Details]
Reason for Immigration Assistance
1. Type of Immigration Service Needed:
☐ Family-Based Petition
☐ Employment-Based Petition
☐ Asylum or Refugee Application
☐ Naturalization or Citizenship
☐ Deportation Defense
☐ Other: [Specify]
2. Describe Your Immigration Goals or Issues:
[Client’s Detailed Description]
