348 Franklin Street
Bloomfield, NJ 07003
Phone: (973) 259-1122

Immigration and Naturalization

*Name:
*Address:
*City:
*State:
Country (if not U.S.)
*Zip:
*E-mail address:
*Home Phone:
Business Phone:
Cellular or Pager:
Facsimile:
Are you known by any other names?
YesNo
If yes, list other names you have used:
What is your marital status?
Do you have a job offer from a U.S. employer?
YesNo
If yes, please provide the employer's name and address, and a description of the job you have been offered.
Do you have family members now living in the U.S.?
YesNo
If yes, please provide the name and address of your family member, and describe how you are related to that family member.
Are you married to a U.S. citizen?
YesNo
If yes, please provide your spouse's name and address, and the date and place of your marriage.
Please set out the reason or reasons you wish to enter, or remain in, the U.S.
If you are applying for a visa to enter the U.S., do you wish to bring members of your family with you?
YesNo
If yes, please provide their names, addresses, and their relationship to you.
Have you ever entered the U.S. on a visa other than a tourist visa?
YesNo
If yes, please provide the dates you were in the U.S., and the type of visa used.
Have you ever been denied permission to enter the U.S., or ordered to leave the U.S.?
YesNo
If yes, please give the reason and the relevant dates.
Have you ever been convicted of a crime?
YesNo
If yes, please provide the details, including the offense for which you were convicted, the sentence or penalty imposed, and the date of the offense.
If you are now in the U.S., have you been ordered to leave, or do you believe you may be ordered to leave?
YesNo
If yes, please provide the details, including the reason for the order.
Are you making a claim for political asylum?
YesNo
If yes, please provide the details, including the reasons for your claim.
How would you rate your legal needs described here?
Have other attorneys worked on this matter?
YesNo
If yes, provide names, addresses, and a brief description of their involvement:
Special concerns:
Where did you hear about this website?
 

NOTE: The use of the Internet for communications with the firm will not establish an attorney-client relationship and messages containing confidential or time-sensitive information should not be sent.


The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for individual advice regarding your own situation.