New Lead

New Client Information Form

Please complete the form below to help us better understand your case and provide tailored assistance. All fields marked with * are required.

First Name *

Middle Name

Last Name *

Gender

Email Address *

Country Code *

Phone Number *

Date of Birth

Nationality *

Street Address

City

State/Province

Zip/Postal Code (Five digits only) *

Please enter a valid 5-digit Zip Code.

Country

Immigrant Status *

Expiration Date

Are you Legal Permanent Resident (LPR)? *

Yes

Since when?

Has someone ever filed an application or petition on your behalf?

Yes

Were your parent(s) or your grandparents U.S. citizens?

Yes

What is your marital status?

How many times have you been married?

Spouse's Information

Full Name

Date of Birth

Nationality

Date of Marriage

Email Address

Country Code

Phone Number

Spouse's Immigrant Status

How many children do you have?

PROVIDE THE FOLLOWING INFORMATION OF THE CHILDREN

Age:

Immigration Status:

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Provide a list of the applicant's entries and departures from the US:

Entry Date:

Entered with Permission?

Yes

Departure Date:

Reason for Leaving the US:

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DEPORTATION HISTORY (IF ANY)Have you ever been ordered removed or deported from the U.S.? *

Yes

Have you ever been in immigration court?

Yes

Have you ever been stopped by immigration officials?

Yes

CRIMINAL HISTORY (IF ANY)Have you ever been arrested? *

Yes

If yes, provide the following:

Date of Arrest:

City/State of Arrest:

Charges:

Outcome:

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Have you ever been convicted of a misdemeanor or felony? *

Yes

Have you ever been a victim of domestic abuse by a spouse, parent or child?

Yes

Have you ever been the victim of a crime? *

Yes

If so, what crime?

Have you ever been denied a visa? *

Yes

Reason for consultation: *

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