Immigration Form for Beneficiary

Place of last arrival in the U.S. (City & State)
Passport or Travel document number used at last arrival
Country that issued this Passport or Travel document
Nonimmigration Visa #:
Date Visa Issued:

MonthDayYear
Country of Visa Issuance (City & State)
Current Marital Status (Married, Single, Widower)
Date of Marriage:

MonthDayYear
Place of Marriage (City & State)
- Full Name of Previous Spouse
  
  First NameMiddle NameLast Name
- Place of Marriage:
- Date of Marriage Termination:
  
  MonthDayYear
- Place of Marriage Termination

Where did you live within the past 5 years?
From (MM/DD/YY) To (MM/DD/YY)

Address
Street Address Address Line 2
City State Zip
From (MM/DD/YY) To (MM/DD/YY)

Address
Street Address Address Line 2
City State Zip
From (MM/DD/YY) To (MM/DD/YYY)

Address
Street Address Address Line 2
City State Zip

Where did you work/study within the past 5 years?
From (MM/DD/YY) To (MM/DD/YY)

Occupation or Major:

Address of Work/Study
Street Address   Address Line 2
City   State   Zip
From (MM/DD/YY) To (MM/DD/YY)

Occupation or Major:

Address of Work/Study
Street Address   Address Line 2
City   State   Zip
From (MM/DD/YY) To (MM/DD/YY)

Occupation or Major:

Address of Work/Study
Street Address   Address Line 2
City   State   Zip
Last Physical Address of Beneficiaries Outside the United States

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please Bring Following Documents that are needed.

1. Copy of marriage certificate

2. Copy of divorce decrees (if any)

3. Copy of Birth certificate

4. Copy of Visa

5. Copy of your country passport

6. Copy of entry stamp or I 94 form

7. 6 passport photos

8. Medical form by immigration doctor
(Doctors Link https://www.uscis.gov/tools/find-a-civil-surgeon)

Next Step: After you Submit this form you can book an appointment with us online or call us on 929-292-9230.
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