Immigrant Defendant Questionnaire
General Information
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Country of Birth
Date of Birth
-
Month
-
Day
Year
Date
Marital Status
Single
Married
Divorced
Widowed
If married, is your spouse a United States citizen?
Yes
No
Immigration Information
Are you in custody?
Yes
No
Has ICE issued a detainer?
Yes
No
Did you tell any border official that you intended to apply for asylum?
Yes
No
Did any border official ever interview about your fear of returning to your home country?
Yes
No
Date of Last Entry
-
Month
-
Day
Year
Date
Visa Type
How did you last enter the United States?
Airport
Sea
Car
Other
Are you a Lawful Permanent Resident (LPR)?
Yes
No
If yes, how did you become an LPR?
Family
Employment
Refugee
Other
If yes, when did you become an LPR?
-
Month
-
Day
Year
Date
Did either one of your parents become a United States citizen prior to your 18th birthday?
Yes
No
Are either one of your parents an LPR?
Yes
No
Not Sure
Do any of the following apply to you?
Undocumented
Unknown Status
Received Employment Authorization
Refugee
Asylee
Temporary Protected Status
U Visa
DACA
T Visa
Other
Immigration Documents (Passport, Visa, Birth Certificate, etc.)
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Prior Orders of Removal/Deportation/Voluntary Departure
Have you ever been ordered deported/removed or received voluntary departure?
Yes
No
Not Sure
Have you ever been in front of an immigration judge?
Yes
No
Not Sure
If yes, please describe what happened.
When and where were you ordered deported/removed or given voluntary departure?
Immigration Court Documents (Notice to Appear, Order of Removal or Voluntary Departure, etc.)
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Criminal History
Have you ever been the victim of a crime?
Yes
No
Did you report the crime?
Yes
No
If yes, what was the crime? When and where did it occur?
If you are under 18, have you ever been abused, neglected, or abandoned by a parent?
Yes
No
Have you ever been convicted of a crime?
Yes
No
Did you ever receive a suspended sentence?
Yes
No
Crime, Charge, Conviction, and Sentence
Do you have any currently pending charges against you?
Yes
No
Crime, Charge, Plea Offers
Criminal Records (Charges, Conviction Record, Sentencing Documents)
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