Consultation Questionnaire

 

 

IMMIGRATION LEGAL TEAM - 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 & CHANG, LLC by: ________________________________

 

Brief description of the factual situation leading you to seek a consultation from BOGLE & CHANG:

 

______________________________________________________________________________________________________

 

______________________________________________________________________________________________________

 

______________________________________________________________________________________________________

 

______________________________________________________________________________________________________

 

______________________________________________________________________________________________________

 

______________________________________________________________________________________________________

 

Information from the Foreign National: (If person attending the consultation is not the foreign national, please complete the information that youknow 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)________________________________________________________________________________________________

 

______________________________________________________________________________________________________

 

______________________________________________________________________________________________________

 

_________________________________________________________________

 

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.:_________________________________________________________________________

 

______________________________________________________________________________________________________

 

______________________________________________________________________________________________________

 

______________________________________________________________________________________________________

 

____________________________

 

Provide all prior periods of stay in the United States by children and type of visa:(From) (To) (Type )

 

______________________________________________________________________________________________________

 

______________________________________________________________________________________________________

 

________________________________________________________________________________

 

(Any children born in U.S.?

If so, please indicate.)____________________________________________________________________________________

 

______________________________________________________________________________________________________

 

______________________________________________________________________________________________________

 

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?_________________________________________________________________________________________________

 

______________________________________________________________________________________________________

 

______________________________________________________________________________________________________

 

Please list any arrests, charges and/or convictions including traffic violations:

 

______________________________________________________________________________________________________

 

 

______________________________________________________________________________________________________

 

 

______________________________________________________________________________________________________

 

 

______________________________________________________________________________________________________

 

 

Has the foreign national ever been fingerprinted for any reason, whatsoever?______________

 

For Yes, Explain circumstances_____________________________________________________________________________

 

When_______________________Where_____________________________________________________________________

 

____________________________________________________________________Why______________________________

 

______________________________________________________________________________________________________

 

______________________________________________________________________________________________________

 

______________________________________________________________________________________________________

 

 

I understand that providing this information to BOGLE & CHANG, 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 & CHANG, LLC.

 

Completed By:________________________________________________________

 

Signature ___________________________________________________________

 

PRINT NAME ________________________________________________________

 

DATE: ________________________________________________________

 

 

 

BOGLE & CHANG, LLC

 

Phone: (800) 342-1733

Fax: (617) 674-2396

Email to: lawyer@immigrationlegalteam.com