BOGLE & ASSOCIATES, LLC
Phone: (866) 788-5529 Fax: (866) 414-3499
Email to: info@bogle-associates.com
CONSULTATION QUESTIONAIRE **(PLEASE PRINT)**
Information about the individual attending the consultation:
Date:___________________________________
Full Name:_______________________________________________________ Date of Birth: ______________
Address:_______________________________________________________________________
(Street) (Apt. #) (City) (State) (Zip)
Phone (work):_____________Phone (home):_____________
E-mail address: _______________________
Fax (home):_______________________Fax (work): _______________________
Referred to BOGLE & ASSOCIATES, LLC by: _______________________
Brief description of the factual situation leading you to seek a consultation from BOGLE & ASSOCIATES, LLC:
___________________________________________________________________________________________
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Information from the Foreign National: (If person attending the consultation is not the foreign
national, please complete the information that you know concerning the foreign national who is
the subject of the consultation)
Is the foreign national in the U.S.? ______ If so, last date of entry to U.S: _____________________________
Status at time of entry:_____________________(Tourist, Student, Without inspection, etc.)
Expiration date of I-94____________________________________
Immigration Number (As contained on foreign national’s work card, green card or any documents for the UCIS or
Court) A#:__________________________
Social Security Number (if any):_________________________
Other names used:_____________________________
Foreign national’s place of birth (city/state/Country):
___________________________________________________
Any right to citizenship in country other than country of birth: Yes____ No____
Is the foreign national employed by a U.S. employer? Yes____ No____
If so, name and address of U.S. Employer: _______________________
___________________________________________________________________________________________
Please provide the foreign national’s prior periods of stay in the United States and type of visa:
(From) (To) (Type )
__________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
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Has the foreign national ever stayed beyond the date on the I-94 Arrival/Departure record?:________________
Has the foreign national ever worked without Citizenship and Immigration Service Permission?: _____________
Marital Status of foreign national (circle one): Single____ Married____ Divorced ____Widowed ____ Civil Union
____
Spouse's Name:____________________________________________
(Husband or Wife, also give maiden name for wife)
Date of Marriage:______________________
Place of Marriage:________________________________________
(City, State, Province, Country)
Spouse's Status in the U.S.:__________________________________
Location of Spouse:________________________________________
If spouse is not a U.S. citizen, please provide all prior periods of stay in the United States by spouse of foreign
national and type of visa:
(From) (To) (Type )
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
List children with Date, Place of birth (City, State, Country) & current immigration status if in U.S.:
___________________________________________________
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Provide all prior periods of stay in the United States by children and type of visa:
(From) (To) (Type )
___________________________________________________
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___________________________________________________
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___________________________________________________
(Any children born in U.S.? If so, please indicate.)
___________________________________________________
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Does the Foreign National have any U.S. Citizen parents or grandparents? Yes____ No
Please provide details if known: ___________________________________________________
___________________________________________________________________________
Has the foreign national ever appeared before an Immigration Judge?: Yes___ No ___
When:____________ Where:________________________
Result:_______________________
Attorney on case:______________________________
Phone:______________________________
Previous applications made to USCIS (formerly INS): _________________________________________________
_____________________________________________________________________________
Is the foreign national afraid to return to his/her country of Citizenship/Nationality? Why?
___________________________________________________________________________________________
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Please list any arrests, charges and/or convictions including traffic violations:
______________________________________________________________________
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Has the foreign national ever been fingerprinted for any reason, whatsoever?______________
For Yes, Explain circumstances__________________________________________________________________
When ________________________
Where__________________________________________________________________
_______________________________________________________________________
Why_______________________________________________________________________________________
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I understand that providing this information to BOGLE & ASSOCIATES, LLC is for the purpose
of obtaining a consultation and is not intended for the purpose of establishing an attorney
client relationship until I have executed a written legal services agreement entering into such a
relationship with the BOGLE & ASSOCIATES, LLC.
Completed By:________________________________________________________
Signature ___________________________________________________________
PRINT NAME ________________________________________________________
DATE:______________________