Immigration Intake Form

*Name:

*Address:

*City:

State:

Country (if not U.S.)

*Zip:

*E-mail address:

*Home Phone:

Business Phone:

Cellular or Pager:

Facsimile:

Are you known by any other names?
Yes  No 

If yes, list other names you have used:

What is your marital status?

Do you have a job offer from a U.S. employer?
Yes  No 

If yes, please provide the employer's name and address, and a description of the job you have been offered.

Do you have family members now living in the U.S.?
Yes  No 

If yes, please provide the name and address of your family member, and describe how you are related to that family member.

Are you married to a U.S. citizen?
Yes  No 

If yes, please provide your spouse's name and address, and the date and place of your marriage.

Please set out the reason or reasons you wish to enter, or remain in, the U.S.

If you are applying for a visa to enter the U.S., do you wish to bring members of your family with you?
Yes  No 

If yes, please provide their names, addresses, and their relationship to you.

Have you ever entered the U.S. on a visa other than a tourist visa?
Yes  No 

If yes, please provide the dates you were in the U.S., and the type of visa used.

Have you ever been denied permission to enter the U.S., or ordered to leave the U.S.?
Yes  No 

If yes, please give the reason and the relevant dates.

Have you ever been convicted of a crime?
Yes  No 

If yes, please provide the details, including the offense for which you were convicted, the sentence or penalty imposed, and the date of the offense.

If you are now in the U.S., have you been ordered to leave, or do you believe you may be ordered to leave?
Yes  No 

If yes, please provide the details, including the reason for the order.

Are you making a claim for political asylum?
Yes  No 

If yes, please provide the details, including the reasons for your claim.

How would you rate your legal needs described here?

Have other attorneys worked on this matter?
Yes  No 

If yes, provide names, addresses, and a brief description of their involvement:

Special concerns:

Where did you hear about this website?

 

The contents of this contact form are provided by and are the responsibility of the person posting the email communication. Your email will not create an attorney-client relationship and will not necessarily be treated as privileged or confidential. You acknowledge that any reliance on material in email communications is at your own risk.

Based in San Jose, California, the U.S.A. immigration lawyers at the Law Offices of Marcine A. Seid offer businesses and individuals immigration and visa services throughout the United States, including the all major U.S. ports of entry such as New York City (NYC), NY, Miami, Florida, Dallas, Texas, Seattle WA, Chicago IL, Los Angeles CA, Washington DC, Austin TX, and Research Triangle in Raleigh-Durham NC. Our U.S. immigration attorneys can help you with your immigration matter.

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