Initial Client Questionnaire


1. Your Full Name

2. Contact Information

3.

4.

5. Passport

6. Visa

7.

8.

If yes to (d), answer (e):

9.

10.

11.

YOUR OCCUPATION

12. CURRENT PROFESSION / OCCUPATION

13. PRIOR EMPLOYMENT - Past 5 years

14. EDUCATION / TRAINING

15.

16.

17.Marital Status

IF DIVORCED OR WIDOWED, FILL OUT (f) through (g)

18. Your Children

19. Your Father

20. Your Mother

21. Other Family

If yes, provide namesaddressplace of birthdate of birth and immigration status (if in U.S.)

22. List Your Residences for the Last 5 Years

23. YOUR HEALTH

24.

25.

26. PERSONAL BACKGROUND (for purposes of qualifying for immigration).

f. APPLICANTS FOR STATUS AS PERMANENT RESIDENTS MUST ESTABLISH THAT THEY ARE ADMISSABLE TO THE UNITED STATES. EXCEPT AS OTHERWISE PROVIDED BY LAW, ALIENS WITHIN ANY OF HTE FOLLOWING CLASSES ARE NOT ADMISSIBLE TO THE UNITED STATES AND ARE THEREFORE INELIGIBLE FOR STATUS AS PERMANENT RESIDENTS.

Aliens who have committed or who have been convicted of a crime involving moral turpitude (does not include minor traffic violations); aliens who have been engaged in or who intend to engage in any commercialized sexual activity; aliens who are or at any time have been, anarchists, or members of or affiliated with any Communist or other totalitarian party, including any subdivision or affiliate thereof; aliens who have advocated or taught either by personal utterance, or by means of any written or printed matter, or through affiliation with an organization (i) opposition to organized government, (ii) the overthrow of government by force or violence, (iii) the assaulting or killing of government officials because of their official doctrine of the world communism, or the establishment of a totalitarian dictatorship in the United States; aliens who intend to engage in prejudicial activities or unlawful activities or subversive nature; aliens who have been convicted of violation of any law or regulation related to narcotic drugs or marijuana; aliens who have been involved in assisting any other aliens to enter the United States in violation of law; aliens who have applied for exemption or discharge from training or service in the Armed Forces of the United States on the ground of alienage and who have been relieved or discharged from such training or service; medical graduates (other than those for whom Relative petitions have been approved) coming principally to perform services as members of the medical profession, unless they have passed Parts I and II of the National Board of Medical Examiners Examination (or an equivalent examination as determined by the Secretary of Health, Education, and Welfare) and who are competent in oral and written English.

g. Aliens who are mentally retarded, insane, or have suffered one or more attacks of insanity, aliens afflicted with psychopathic personality, sexual deviation, mental defect, narcotic drug addiction, chronic alcoholism or any dangerous contagious disease; aliens who have a physical defect, disease or disability affecting their ability to earn a living; aliens who are paupers, professional beggars or vagrants; aliens who are polygamists or advocate polygamy; aliens who intend to perform skilled or unskilled labor and who have not been certified by the Secretary of Labor; aliens likely to become a public charge; aliens who have been excluded from the United States within the past year, or who at any time have been deported from the United States, or who at any time have been removed from the United States at Government expense; aliens who have procured or have attempted to procure a visa by fraud or misrepresentation; aliens who have departed from or remained outside the United States to avoid military service in the time of war or national emergency; aliens who are former exchange visitors who are subject to, but have not complied with, the two-year foreign residence requirement.

27.

This consultation will be treated confidentially but does not create an ongoing attorney / client relationship.

I swear that I have read or have had read to me in my native language, the above questions, and that my answers are true and complete.