General Immigration Questionnaire

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I. Information Regarding Alien Applicant

Applicant Name(Required)

Prefix First Last Suffix

Other names (Maiden, Religious, Professional, Aliases)

Sex

Male

Female

Date of birth(Required)

Place of birth (City, State, Country)(Required)

Citizenship (Country)(Required)

U.S. Social Security No.

Permanent address abroad(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

E-Mail(Required)

Enter Email Confirm Email

Telephone(Required)

Facsimile

U.S. address

Street Address Address Line 2 City State ZIP Code

U.S. Telephone

U.S. Facsimile

If in the U.S., complete the following:

Date of arrival

I-94 No.

Current nonimmigrant status

Status expires

Place where last entered U.S.

Means of travel into U.S.

Did you talk with a Border or Pre-Flight Inspector on entry into U.S.?

Yes

Passport No.

Passport date issued

Passport date expires

Color of hair

Color of eyes

Complexion

Height

Have you EVER falsely claimed to be a U.S. citizen (in writing or any other way)?(Required)

Yes

If yes, please provide details(Required)

Marks of identification

tattoos, scars, etc.

Were any of your or your spouse’s grandparents born in the United States?

Yes

If yes, when?

Are either you or your spouse an American Indian born in Canada of at least 50 percent Native bloodline?

Yes

Are either you or your spouse eligible for a Native American tribal document?

Yes

Employment Information (Applicant)

Name of current employer

Employer address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Job title

Current Annual Income ($)

If not currently working, are you retired?

Yes

II. Marital Information (Applicant)

Marital status(Required)

Married

Widowed

Divorced

Separated

Single

Will your spouse accompany you to the U.S.?

Yes

Spouse's Name

Prefix First Last Suffix

Spouse – Other names (Maiden, Religious, Professional, Aliases)

Spouse Sex

Male

Female

Spouse – Date of birth

Spouse – Place of birth (City, State, Country)

Spouse – Citizenship (Country)

Spouse – U.S. Social Security No.

Date of marriage

Place of marriage

Spouse’s former spouse(s)

Full Name

Country of Citizenship

Date of Divorce/Death

Is your spouse currently working in the U.S.?

Yes

If yes, does your spouse have authorization to work full-time?

Yes

If no, does your spouse wish to work in the U.S.?

Yes

Were you previously married?

Yes

Your former spouse(s) (Applicant)

Full Name

Date of Birth

Place of Birth (City/State/Country)

Citizenship

Date of Divorce/Death

Place of Divorce

Do you have any children or stepchildren?

Yes

Children / Stepchildren

Full Name

Date of Birth

Place of Birth (City/State/Country)

III. Petitioning Family Member/Contact Person (U.S. Citizen or Green Card Holder)

Petitioning Family Member Name

Prefix First Last Suffix

Petitioning Family Member Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Petitioning Family Member telephone number

Petitioning Family Member Email address

Enter Email Confirm Email

Petitioning Family Member Current Nationality

Petitioning Family Member Country of Birth

Petitioning Family Member Country of Citizenship

Petitioning Family Member Date of Birth

Are you a Green Card Holder?

Yes

Employment Information (Petitioning Family Member)

Name of current employer (PFM)

Address (PFM)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Job title (PFM)

Current Annual Income (PFM) ($)

If not currently working, are you retired? (PFM)

Yes

Marital Information (Petitioning Family Member)

Marital status (PFM)

Married

Widowed

Divorced

Separated

Single

Were you previously married? (PFM)

Yes

If yes, how many times? (PFM)

Former spouse(s) (Petitioning Family Member)

Full Name

Date of Birth

Place of Birth (City/State/Country)

Citizenship

Date of Divorce/Death

Place of Divorce

V. Immigration-Related Questions

Are either you or your spouse an American Indian born in Canada of at least 50 percent Native bloodline? (duplicate for completeness)

Yes

Are either you or your spouse eligible for a Native American tribal document? (duplicate for completeness)

Yes

Have you ever been placed in immigration proceedings?

Yes

Type(s) of proceedings

Exclusion

Deportation

Rescission

Judicial proceedings

Proceedings - Where

Proceedings - When

Have you ever applied for a U.S. nonimmigrant visa before?

Yes

Classification

Where

When

Outcome

Issued

Refused

Nonimmigrant visa No.

Has your U.S. visa ever been canceled?

Yes

Plan to apply for immigrant visa abroad?

Yes

If yes, where

Plan to adjust status in U.S.?

Yes

If yes, where

VI. Grounds of Exclusion

Have you ever (in or outside of the United States):

a) Knowingly committed any crime of moral turpitude or a drug-related offense for which you have not been arrested?

Yes

b) Been arrested, cited, charged, indicted, fined or imprisoned for breaking or violating any law or ordinance, excluding traffic violations?

Yes

c) Been the beneficiary of a pardon, amnesty, rehabilitation decree, other act of clemency or similar action?

Yes

d) Exercised diplomatic immunity to avoid prosecution for a criminal offense?

Yes

If YES to a–d, provide details (add rows as needed)

Date

Place (City/State/Country)

Nature of Offense

Outcome

Have you ever received public assistance in the U.S. (other than emergency medical treatment), or are you likely to receive public assistance in the future?

Yes

If yes, explain (include the names and Social Security numbers you used)

Have you ever spoken to an immigration attorney before?

Yes

If yes, please provide name of attorney and reason for your meeting

Attestation

I, the undersigned, certify that the information provided on this questionnaire is true and correct to the best of my knowledge.

Printed Name (type full legal name)(Required)

Prefix First Last Suffix

Date(Required)

Signature (type full legal name)(Required)

Find out why we’re one of the top immigration lawyers in Greensboro. Let us help you today!

Neelam Bhardwaj
is a member of the American Immigration
Lawyers Association

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General Immigration Questionnaire

I. Information Regarding Alien Applicant

If in the U.S., complete the following:

Employment Information (Applicant)

II. Marital Information (Applicant)

III. Petitioning Family Member/Contact Person (U.S. Citizen or Green Card Holder)

Employment Information (Petitioning Family Member)

Marital Information (Petitioning Family Member)

V. Immigration-Related Questions

VI. Grounds of Exclusion

Attestation

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