Instructions:

Please provide us with the largest amount of information as it is possible. We understand that the form is quite long and detailed. However, keep in mind that having all this data accessible gives us a complete picture of the alien's current situation, hence, it will help us provide you with competent and adequate legal adivce and will shorten the amount of time it will take us to process your case and any other documents that must be filed with the Immigration Service or with local authorities, should we assume your legal representation.

Finally, PLEASE READ THE INSTRUCTIONS OF EACH SUB-SECTION and complete only those that are relevant to your case or situation.

Your personal information
Name
Family Name:       Name:     Initial:  Other names you have used (including maiden name):    Sex:  

E-mail:     

Home phone:
Fax:
Work phone number:
Cell phone: 
Social Security:
Country of Citizenship:
  
  
Birth Information:
Birth date:
City or Town:
State or Province:
Country:
About your Passport:
Passport Country:
  
Expires on:
 
Current Address in the United States
Street and number
Town or City: State:    Zip Code: 
Since:    
Last address outside of the United States for over a year
Street and number:
City:    State or Province:     Postal Code: 
Country:

Your addresses in the last 5 years and their corresponding dates:

Instructions: This part of the form is OPTIONAL. However, if we assume your legal representation to process an immigrant petition of any kind, WE WILL NEED this information. If you entered your current address in the US in the spaces above, please do not repeat it here.
 
Street and number:
City:    State or Province:     Postal Code: 
Country:
From:       To:  
 
Street and number:
City:    State or Province:     Postal Code: 
Country:
From:       To:  
 
Street and number:
City:    State or Province:     Postal Code: 
Country:
From:       To:  
 
Street and number:
City:    State or Province:     Postal Code: 
Country:
From:       To:  

Immigration History:

Instructions: Enter all your information related to your immigration status, including any visas and status you and your spouse held in the past. At the bottom of this section PLEASE TELL US ABOUT YOUR PROBLEM AND HOW CAN WE HELP YOU.

Your immigration status:
 Expiration date:
Date of FIRST ENTRY to the United States:
 Date of MOST RECENT entry to the United States:

If you ever had any of the following visas, please let us know here, along with the dates corresponding to each status:

Visa type Dates Visa Type Dates
B Visitor: E Investor:
F Student: H-1B Professional:
J Exchange: K Fiancee:
L Executive: O Extraordinary:
Other:

If any, select which immigration benefits you and your spouse requested and/or received in the past.
Marque cualquiera de estos beneficios que su pareja o usted hayan recibido en el pasado, o que hayan solicitado para el mismo.
Who?
Date of Petition
 Result
Permanent Residence
Family petition
Amnesty
Labor Certification
Political Asylum

Please tell us of any immigration problems you or your spouse ever had in the past, in particular if you have ever been in removal (deportation) or if you were ever denied entry to the United States. Also tell us if you were ever denied an immigration benefit.



Use this space to tell us about your case or actual immigration problem and HOW CAN WE HELP YOU.

Family Data
Instructions: Complete this section if your immigration issue involves a family member, whether your spouse, son, daughter, child, or if your case involves a deportation/removal.

Your spouse is in:             The U.S.       Other Country        I'm single
Name of spouse:
Last Name:       Name:     Middle Initial: 
Other names used, including maiden name:
His/Her address (enter "same" if you live together):
 
Date and Place of Birth:
Date and place of wedding
Country of Citizenship:
Applying with you?
Social Security:
Alien Number:
Immigration Status:
Status expires on:
Sons and Daughters
Total number of children:

Name
Sex		 Date and place of birth Citizenship Immigration
Status		 Expiration
date:		 Applying
with you?

Parents
Name Country of Birth Citizen of: Immigration Status
Your
father:
Your
Mother:*
Spouse's
Father:
Spouse's
Mother*
* Enter the maiden name.

Previous Marriages              ( Check here if not applicable)


Name
Date of
Marriage
Country of
Wedding

Children?		 Reason for
termination		 Date of
Termination		 Country
where
marriage terminated
Yours
Spouse's


Employment History
Instructions: If your immigration issue is labor-based, complete the entire section. Otherwise, please complete ONLY the "Current Employment" and "Employments in the last 5 years" sections.



Current Employmen (alternatively, enter the information of the employer that is petitioning for you).
Employer:
Address:
Position:     Salary:
Recruitment Date:

 Employments in the last 5 years anywhere in the world

Position Employer Country Dates of Work (month/year format)

Professional Certifications and Licenses:

Tell us about all your professional certificates, accreditations and licenses you possess, regardless of the country of issuance:



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


Academic History
Instructions: Complete this section, regardless of the nature of your case. Letting the government know about your academic history is important when requesting any immigration benefit.


Level		 Institution and Country Degree and Concentration Years of Study Finished career?
University/College:
University/College:
Other Education:

Other important information
Instructions: Complete this section regardless of the nature of your immigration problem or question.

Have you ever been arrested or found guilty of any crime, anywhere in the world, regardless of whether your criminal record was subsequently expunged? Have you ever had any problems with the police?
 
If YES, please explain in detail what happened, including information about any convictions or absolutions. 

Have you ever claimed to be a citizen of the U.S.A., or have you used any other names to receive an immigration benefit, or for anything else?

If YES, please explain in detail.

Were you ever denied a visa to enter the U.S.A.? 

If YES, please explain what happened, when, and what type of visa was denied to you. If you ANSWERED this question above, do not repeat your explanation here.


Do you file your taxes with the Internal Revenue Service of the U.S.A., and/or with the Department of Internal Revenue of the Commonwealth of Puerto Rico? Since when have you done so? Tell us in years.


I CERTIFY that I am who I claim to be by Name and Last Name, according to the information I entered in the section labeled "Your personal information", at the top of this form; that, furthermore, the information I entered is true to the best of my knowledge, that I read the terms and conditions of use before opening and completing this form, and that I express my consent to such terms and conditions.


 

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