Immigration Consultation Questionnaire
If you would like to schedule a case evaluation or consultation, please complete the Questionnaire below and fax us all of the documents relevant to your case.  
Thereafter, we will call you to discuss your case in more detail.

The information you submit is STRICTLY CONFIDENTIAL and will not be released without your permission.

The Questionnaire asks for information on the person who is seeking a visa or other immigration benefits.  Consequently, in order for us to get a complete picture of
your situation, it is important that you provide all of the requested information.

The cost of the consultation is $200.00 (U.S.) for the first hour or portion thereof.  You can pay for your consultation by credit card using the PAYPAL Payment
Information link found below. We will credit the cost of the consultation to your total cost if you retain us to represent you on the day of your consultation.




Note Well: Nothing on this site, including submitting a form, requesting information, e-mailing  or calling this Law Office, or any other action shall create an
attorney client relationship.  That relationship only occurs upon the execution of a retainer agreement.
INFORMATION ABOUT YOU
Name
Last:
First:
Middle:
Other names used (including maiden name)
Sex:
E-mail address:
Curent Address in U.S.
Number and Street:
City:
State:
 Zip:
Last Address Outside of U.S.
Number and Street:
City:
State/Province:
Country:
Postal Code:
Home Phone:
Work Phone:
Hour we can call:
Hour we can call:
Fax Number:
Cell Phone:
Social Security No:
Citizen of:
Date and Place of Birth:
Passport Information:
Date of Birth:
Passport Country:
Passport Number:
City or Town:
Expiration Date:
State/Province:
Country:
What type of immigration assistance are you seeking?
FAMILY INFORMATION
Husband or Wife
Outside of U.S.
In the U.S.
 Unmarried
Spouse's Name
Middle:
Last:
 First:
Other names used (including maiden name):
Current Address (put "same" if you live together):
Date and Place of Birth:
Social Security Number:
Date and Place of Marriage:
Alien  ("A")  Number:
Citizen of:
Immigration Status:
Applying with you?
Expiration Date:
Children
Total Number of Sons and Daughters:
Date & Country                                Immigration                Expiration      Applying
Name                           Sex              of Birth             Citizen of                status                          Date         with You?
Parents
Name                                                   Coutry of Birth            Citizen of             Immigration status     
Your Father:
Your Mother*
Spouse's
Father
Spouse's
Mother*
* Use Mother's Maiden Name
Previous Marriages
Check if Not Applicable)
(
Date fo
Termination
of Marriage
 Country of
Termination
of Marriage
Reason for
Termination
of Marriage
Country of
Marriage
Date of
Marriage
Name
Kids?
Your's
Spouse's
IMMIGRATION HISTORY
Current Immigration Status:
Alien  ("A")  Number:
Date Status Expires:
Date of First Entry into U.S.:
Last Entry into U.S.:
I-94 Number:
Check every type of immigration status that you have ever held and provide the dates:
Immigration Status:
Immigration Status:
Date(s)
Date(s)
B Visitor:
E Trader/Investor:
H-1B Professional:
F Student:
K Fiancee:
J Exchange Vistor:
O Outstanding Ability:
L Manager:
T/N Canadian Worker:
Other:
Check each one that you or your spouse have ever applied for or been the beneficiary of:
Y(you) or
S(Spouse)
Result
Attorney
Date Filed:
Sponsor
Green Card
Immigrant pettition
Labor certification
Asylum
Amnesty
Have you or your spouse ever had any immigration problems? In particular, have you or your spouse
ever been under removal, deportation, or exclusion proceedings? Please describe in detail:
EMPLOYMENT HISTORY
Current Employer (or Employer Petitioning on Your Behalf)
Employer:
Address:
Job Title:
Salary:
Date of Hire:
 Are you related to your employer?
May we contact your employer?
If yes, whom may we contact:
Phone Number
Title:
Department:
Name
Employment in Last Five Years (anywhere in the world)
Job Title:
 Employer
Country
Duration
JOB QUALIFICATIONS
List the professional licenses or certifications you possess, from any state or country:
How many years of experience do you have in your position or field?
EDUCATIONAL BACKGROUND
Please list all your education anywhere in the world:
Number of
Year
Graduate?
Level
School/Country
 Degree & Major
Collage/University:
Collage/University:
Other Schooling:
OTHER INFORMATION
Have you ever been arrested or convicted of a crime anywhere in the world (even if the conviction was expunged or
removed from your record) or have you ever had any problems with the police?
If yes, please explain in detail:
Have you ever claimed to be a citizen of the United States or have you ever used another name
for immigration purposes or for any other reason?
If yes, please explain in detail:
Have you ever been denied a visa to come to the United States?
If yes, when and what kind of visa:
During what years, if any, have you filed an Income Tax Return with the IRS?
If you ever had an Employment Authorization Card issued by the INS, give number(s) and validity dates:
Is there anything, not already covered in this form, that you feel we should know?  
STATEMENT OF TRUTHFULNESS
"By pressing the Send Questionnaire button below,
I certify that I have read and understood the instructions above this questionnaire.
I certify that all of the information contained in this form is true and correct to the best of my knowledge."
Type today's date
Type your name
Disclaimer: The information provided herein is provided for informational purposes only and does not purport and is not intended to solicit, initiate, or form an
Attorney-Client relationship.  Moreover, while some of the information found on this site is based on laws and court rulings, it is not intended to be legal advice and must
not be relied upon as legal advice on specific facts.
Law Offices of RL Johnson |  Copyright © 2007 All Rights Reserved.
Competent, Timely,
Compassionate, Affordable
Legal Representation for
Immigrants & Nonimmigrants
Proudly Providing Nationwide Service
Michigan Locations:  Westland, Livonia, &  Berkley     
Phone: (800) 597.0284   Fax:  (800) 597.0284
LAW OFFICES OF RL JOHNSON