Initial Immigration Consultation Intake

1
What are your immigration goals?* This field is required.
Work Permit
Green Card
Citizenship
Asylum
Family Petition
Waiver
Stop deportation
Petition for Habeas Corpus
Labor visa
Other
2
If you selected Labor Visa, please speak to one of our staff. Do not continue with this form.
3
How did you hear about Piñeiro Law?* This field is required.
Please Select
Radio Amor 107.5FM / Jose Antonio & Roxana
Friend of mine
Prior client of your firm
Google
Social Media
4
Have you ever been to Piñeiro Law or consulted with attorney Yunior Piñeiro?* This field is required.
YESNO
5
Have you ever been represented by an attorney before?
YESNO
6
Complete Name* This field is required.
Mr.
Mr.
Mrs.
Dr.
Ms.
Rev.
Prefix
First Name
Middle Name
Last Name
7
Date of Birth* This field is required.
Date
Month
Day
Year
8
Country of Birth* This field is required.
9
Country of CitizenshipThe country that issued your passport.
10
A-Number (if any)Typically found on work permit, green card, or USCIS notices.
11
Phone Number* This field is required.Best phone number to reach you.
Area Code
Phone Number
12
Email* This field is required.
example@example.com
13
Mailing Address
Street Address
Apartment #
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
14
Preferred Language
Please Select
Please Select
English
Español
15
Date of Most Recent Entry
Date
Month
Day
Year
16
Place of Entry
17
Manner of Entry* This field is required.
Please Select
Please Select
Visa
Parole
Without Inspection (EWI)
Other
18
Current Immigration Status* This field is required.
Please Select
Please Select
No Status / Undocumented
DACA
TPS
U.S. Citizen
Lawful Permanent Resident (Green Card)
Visa holder
Other
19
Have you filed immigration applications before?* This field is required.
Yes
No
20
Application(s) FiledPlease list the applications filed and approximate dates (if known).
Please Select
Please Select
Adjustment of Status (I-485)
Work Permit (I-765)
Asylum
Family Petition (I-130)
Waiver (I-601 / I-601A)
Other
21
Have you ever been in immigration court?* This field is required.This information helps us better understand your case. It will not negatively affect your consultation.
Yes
No
22
Court LocationWhich Immigration Court handled your case?
23
Case Status
Please Select
Please Select
Pending
Closed / Terminated
Removal order issued
24
Marital Status
Please Select
Please Select
Single
Married
Divorced
Widowed
Separated
25
Do you have any children under the age of 18?* This field is required.Any child living with you and/or living abroad. Any stepchild.
Yes
No
26
Have you EVER been arrested, charged, or convicted?* This field is required.
Yes
No
27
Do you want to authorize a third party to inquire about your case?* This field is required.
Yes
No
28
Third Party Name
29
Relationship
30
Third Party Phone/Email
31
I understand that this consultation does not create an attorney-client relationship unless a written agreement is signed. I confirm all information is true and complete. No guarantees have been made. Failure to disclose may affect my case.* This field is required.
I acknowledge and agree to the terms above.
32
Signature* This field is required.
33
Date* This field is required.
Date
Month
Day
Year
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Hour
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Minutes
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PM
34
Please verify that you are human* This field is required.
Should be Empty: