Immigration Intake Form - King Law Group, PLLC

First Name (Don't worry. You don't need to fill out the whole thing but the more information you give the more we can help during your initial immigration consultation.)

MI

Last Name

Street Address

Address Line 2

A "Safe" Mailing Address (leave blank if same as Street Address)

City

State

Zip Code

Home Phone

Business Phone

Cell Phone

Email Address

Date of Birth (MM/DD/YYYY)

City and Nation of Birth

Nationality

Other Citizenship?

Yes

No

Please Specify

A Number (green card or work permit)

I94 Number

Type of Non-Immigrant Visa (visitor, fiancé, student, etc.)

Date of First Entry to U.S. (MM/DD/YYY)

Place of First Entry to U.S.

Date of Last Entry to U.S. (MM/DD/YYY)

Place of Last Entry to U.S.

Are you known by any other names? (Include maiden or native alphabetic spelling.)

Yes

No

List other names you have used

Are you currently married?

Yes

No

Is your spouse a U.S. Citizen?

Yes

No

Do you have any children?

Yes

No

How many children do you have?

Are any of your children U.S. Citizens?

Yes

No

Do you have a job or offer from a U.S. employer?

Yes

No

Please provide the employer's name and address, and a description of the job you have been offered.

Do you have family members now living in the U.S.?

Yes

No

Please provide the name and address of your family member, and describe how you are related to that family member.

Please set out the reason(s) you wish to enter, or remain in, the U.S.

If you are applying for a visa to enter the U.S., do you wish to bring members of your family with you?

Yes

No

Have you ever entered the U.S. on a visa other than a tourist visa?

Yes

No

Please provide the dates you were in the U.S., and the type of visa used.

Have you ever been denied permission to enter the U.S., or ordered to leave the U.S.?

Yes

No

Please give the reason and the relevant dates.

Have you ever been convicted of a crime (other than non-criminal traffic offense)?

Yes

No

Please provide the details, including the offense for which you were convicted, the sentence or penalty imposed, and the date of the offense.

If you are now in the U.S., have you been ordered to leave, or do you believe you may be ordered to leave?

Yes

No

Please provide the details, including the reason for the order.

Are you making a claim for political asylum?

Yes

No

Please provide the details, including the reasons for your claim.

Have other attorneys worked on this matter?

Yes

No

Please provide the details, including the reasons for your claim.

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