G. L. Grobsmith, LLC Immigration Services Intake Form

G. L. Grobsmith, LLC - IMMIGRATION ASSISTANCE Immigration Client Intake Form

This form collects information for immigration document preparation and assistance. We do not provide legal advice or legal representation.
SECTION 1: BASIC CLIENT INFORMATION
Full Legal Name (First, Middle, Last)*

First NameMiddle NameLast Name
Preferred Name (if different)
Date of Birth*

MonthDayYear
Date
Country of Birth*
Country of Citizenship*
Gender (Optional)
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address*
example@example.com
Current Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Preferred Language*

EnglishSpanishOther (please specify)

SECTION 2: IMMIGRATION STATUS
Current Immigration Status*

U.S. CitizenLawful Permanent Resident (Green Card Holder)Visa HolderNo Current StatusUnsure
If you have a status, select type (if known)
I entered the U.S.:*

With a visaWithout inspectionI am outside the U.S.
Date of last entry to the U.S. (if applicable)

MonthDayYear
Date

SECTION 6: DOCUMENTS (UPLOAD)
Please upload any documents you already have (if available):(Passport, Visa, I-94, Previous USCIS notices, Work permit, Green card, Birth certificate, Marriage certificate, etc.)

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SECTION 7: IMPORTANT DISCLOSURES
Legal Disclaimer (Required)*

I understand that G. L. Grobsmith LLC is not a law firm and does not provide legal advice.I understand that services provided are limited to immigration document preparation and assistance.
Accuracy Statement (Required)*

I certify that all information provided is true and correct to the best of my knowledge.
Consent to Contact (Required)*

I consent to be contacted by phone, email, or text regarding my case.

G. L. Grobsmith, LLC - IMMIGRATION ASSISTANCE Immigration Client Intake Form