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Immigration
Qualification Form
Below is a questionnaire to help us assess your situation. Fill the form to the best of your ability.
Call Us
Email Us
Please enable JavaScript in your browser to complete this form.
Name
*
First
Middle
Last
Do you identify yourself by any other name(s)?
*
Yes
No
If Yes to the prior question, what other names do you identify?
U.S. Social Security Number (if any):
Alien Registration Number(s) (A-Number) (if any):
USCIS Online Account Number (if any):
Residence in the U.S. (physical Address):
*
Mailing Address in the U.S. (if different than the address above):
Telephone Number:
*
E-mail Address:
*
Gender (Pick One):
*
Male
Female
Marital Status (Pick One):
*
Single
Married
Divorced
Widowed
Date of Birth (mm/dd/yyyy):
*
City of Birth:
*
Country of Birth:
*
Present Nationality (Citizenship):
*
Nationality at Birth:
*
Race, Ethnic, or Tribal Group:
*
Religion:
*
Pick the one that applies on you:
*
I have never been in Immigration Court proceedings.
I am now in Immigration Court Proceedings.
I am not now in Immigration Court proceedings, but I have been in the past.
When did you last leave your country? (mm/dd/yyyy):
What is your current I-94 Number (if any)?
List each entry into the U.S. beginning with your most recent entry.
What country issued your last passport or travel document?
*
Passport Number:
*
Expiration Date(mm/dd/yyyy):
*
Travel Document Number:
What is your native language?
*
Are you fluent in English?
*
Yes
No
What other languages do you speak fluently?
List your last address where you lived before coming to the U.S.
*
Provide information about your residences during the past 5 years. (List your present address first).
*
Provide information about your education. (Begin with the most recent school that you attended).
*
Provide information about your employment during the past 5 years. (List your present employment first).
*
Mothers Name
*
First
Middle
Last
Living? (Pick No if passed away)
*
Yes
No
City/Town of Birth?
*
Country of Birth
*
Current Location?
*
Fathers Name
*
First
Middle
Last
Living? (Pick No if passed away)
*
Yes
No
City/Town of Birth?
*
Country of Birth
*
Current Location?
*
Sibling(s) Information
*
Are you doing or have you ever done anything illegal and or against the law anywhere in the world?
*
Yes
No
If Yes, Explain:
Have you ever been arrested, convicted, or cautioned for a crime anywhere in the world for any reason, including driving violation, DIU, alcohol/drugs/consuming/smuggling etc. related offense?
*
Yes
No
If Yes, Explain:
Have you ever been removed from or deported from the United States?
*
Yes
No
If Yes, Explain:
Have you ever overstayed beyond the period authorized by U.S. immigration?
*
Yes
No
If Yes, Explain:
Have you ever had any prior visa application denied?
*
Yes
No
If Yes, Explain:
Do you have any essential information related to you or to your family members that you want to declare?
*
Yes
No
If Yes, Explain:
Do you have any special talents, skills, inventions, abilities, or awards?
*
Yes
No
If Yes, Explain:
Are you Married?
*
Yes
No
Spouses Name
First
Middle
Last
Has spouse ever gone by another name?
Yes
No
If Yes, Explain:
[Spouse] Alien Registration Number (A-Number) (if any):
[Spouse] Passport/ID Card Number (if any):
[Spouse] Date of Birth (mm/dd/yyyy):
[Spouse] U.S. Social Security Number (if any):
[Spouse] Date of Marriage (mm/dd/yyyy):
Place of Marriage:
[Spouse] City and Country of Birth:
[Spouse] Nationality (Citizenship):
[Spouse] Race, Ethnic, or Tribal Group:
[Spouse] Gender
Male
Female
[Spouse] Is this person in the U.S.?
Yes
No
If No (Where at?)
If Yes - Place of last entry into the U.S:
If Yes - Date of last entry into the U.S. (mm/dd/yyyy):
If Yes - I-94 Number (if any):
If Yes - Status when last admitted (Visa type, if any):
If Yes - What is your spouse's current status?
If Yes - What is the expiration date of his/her authorized stay, if any? (mm/dd/yyyy):
Is your spouse in Immigration Court proceedings?
Yes
No
If Yes - If previously in the U.S., date of previous arrival (mm/dd/yyyy):
If Yes - If in the U.S., is your spouse to be included in this application?
Yes
No
Do you have children?
Yes
No
If Yes, How many children do you have?
Additional information or comments?
Comment
Submit
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Home
About
Practice
Civil Cases
Personal Injury Lawyer in Tampa
Car Accident Lawyer in Tampa
Motorcycle Accidents
Truck Accidents
Bicycle Accidents
Wrongful Death
Slip and Fall
Pedestrian Accidents
Criminal Defense
Criminal Defense
DUI & BUI
Traffic Infractions
Real Estate
Real Property Law
Realtor Services
Title & Closing
Insurance Defense
Bad Faith Insurance Claims
Florida Hurricane Insurance Claim Disputes
Legal Areas
Bankruptcy
Business Consulting
Contracts & Business
Estate Planning
FDA Compliance and Regulatory Guidance Services
FDA Label Review
FDA Registration
FDA Compliance – Request Form
Immigration
Immigration Qualification Form
Immigration From the Middle East to America
Frequently Asked Immigration Questions
Free Consultation
Make a Payment
Tampa Office
3702 W Spruce St #1076
Tampa, FL 33607
T:
(813)461-4473
E:
[email protected]
Mahmud Yennes, ESQ.