IMMIGRATION INTAKE FORM

IMMIGRATION INTAKE FORM
This immigration form is used to request a 1 hour consultation with a qualified paralegal. To book your appointment, please fill out the form completely and include any specific questions you would like to ask during the consultation. A $200 payment is required to secure your booking. Once the form and payment are received, we will contact you to schedule your appointment. Our business hours are Monday through Friday, from 9:00 AM to 5:00 PM. You will receive credit against your case, once contracted.
General Info
Case number
Client Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Address
Phone Number
Format: (000) 000-0000.
Other Names
Email
example@example.com
Country of Origin
Passport Country
Passport Number
ANumber
Immigration Status
How long?
How long?
Work Authorization?
How long?
Work Authorization?
How long?
Work Authorization?
Date granted?

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Work Authorization?
Expiration Date?

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Prior Immigration Attorney Info
Name
Firm
Time in the US
Date of First Arrival

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Departures from the US Since First Arrival: (dates, duration, and reason for departure)
Prior Removal or Voluntary Departure
Where?
When?
Where?
When?
Criminal History
1. Offense
Misd. or Felony
Location
Date Offense Committed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
End Result
Date of Sentence

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Length of Sentence Imposed (including time suspended):
Time Served in Custody:
Release Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
2. Offense
Misd. or Felony
Location
Date Offense Committed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
End Result
Date of Sentence

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Length of Sentence Imposed (including time suspended):
Time Served in Custody:
Release Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Criminal History
1. Spouse Name
Do your spouse reside in the US?
US Immigration Status (if any):
Place of Current Marriage
Date of Current Marriage

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
2. Mother's Name:
Does your mother reside in the US?
US Immigration Status (if any):
Place of Birth
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
3. Father's Name
Do your father reside in the US?
US Immigration Status (if any):
Place of Birth
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
4. Child's Name
Do your child reside in the US?
US Immigration Status (if any):
Place of Birth
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
5. Child's Name
Do your child reside in the US?
US Immigration Status (if any):
Place of Birth
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
6. Child's Name
Do your child reside in the US?
US Immigration Status (if any):
Place of Birth
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
How did you hear about us?
What type of immigration assistance are you seeking? Please list your questions.
***DISCLAIMER: LA DOÑA isn't a law firm and can't provide legal advice, but can refer you to the right attorney who can.***
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