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Purpose: To
obtain the facts necessary for an immigration lawyer to determine
immigration consequences of a criminal conviction.
Documents:
Photocopy any immigration documents/passport.
Client's Name: _________________________
DOB: _______
Date of Interview:
______ Immigration Hold: YES NO
Criminal History:
Rap sheets needed before calling.
Client's Immigration
Lawyer:
Name: _____________________________
Address:___________________________
Telephone Number:( )__________ ______________
1. Entry: Date
first entered U.S.? ______
Visa Type:____________
Significant departures:
Date: _____________
Length: _________________
Purpose: ____________________________________
Date last entered
US? _____________
Entered w/inspection?
_____ w/o inspection? _____
Visa Type: ____________________
2. Immigration
Status:
Lawful permanent resident?
YES NO
If so, date client
obtained green card?
___________________
Other special immigration
status:
| ___ Undocumented |
___ Refugee |
| ___ Asylee |
___ Temp. Resident |
| ___ Undocumented |
___ TPS |
| ___ Family Unity |
___ ABC |
| ___ Work Permit |
Expires _____ |
Date Visa Obtained
_____
Did anyone ever file
a visa petition for you? YES NO
Name and number:___________________________
Date? ______.
Type of visa petition?
____________
Was it granted? YES
NO
3. Prior Deportations:
Have you ever been
deported by an INS judge? YES NO
Date? __________________
Reason? _____________________________________________
Do you have an immigration
court date pending? YES NO
Reason? ____________________
Date? _________________________
4. Prior Immigration
Relief: Ever before received a waiver of deportability [§
212(c) relief or cancellation of removal] or suspension of deportation?
YES NO
Which: ______ Date:
_______
5. Relatives with
Status:
Do you have a US
citizen (parent, spouse, brother, sister or child -- DOB(s)
_________)?
Do you have a lawful
permanent resident (spouse) or (parent)?
6. Employment:
Would your employer help you immigrate? YES NO
Occupation: __________________________________________________
Employer's name: __________________________________
Phone Number: _____________________________________
7. Possible Unknown
US Citizenship:
Were your or your
spouse's parent or grandparent
born in the US or granted US citizenship?
YES NO One Parent? ____ Both Parents? ____
Were you an unmarried
permanent resident under the age of 18 when one or both parents
naturalized to US citizenship?
YES NO
8. Have you been abused
by your spouse or parents?
YES NO
9. In what country
were you born? _________________
Would you have any
fear about returning? YES NO
Why? ___________________
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