| GENERAL INFORMATION | |||||||||||||||||||||||||||||
| Full Name (First/Middle/LAST): | |||||||||||||||||||||||||||||
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Other Names Used (Maiden):
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Sex (Male or Female):
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| U.S. Address: | |||||||||||||||||||||||||||||
| Home Telephone: | |||||||||||||||||||||||||||||
| Office Telephone: | |||||||||||||||||||||||||||||
| Fax Number: | |||||||||||||||||||||||||||||
| Email Address: | |||||||||||||||||||||||||||||
| Date of Birth (mo/day/year): | |||||||||||||||||||||||||||||
| Place of Birth (City, State/Province, Country): | |||||||||||||||||||||||||||||
| U.S. Social Security Number (if any): | |||||||||||||||||||||||||||||
| Alien Registration Number (if any): | |||||||||||||||||||||||||||||
| Date and Place of Present Marriage: | |||||||||||||||||||||||||||||
| List Your Current Yearly Salary: | |||||||||||||||||||||||||||||
| List the Last Three Years You Filed a Federal Income Tax Return: | |||||||||||||||||||||||||||||
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| INFORMATION ABOUT YOU | |
| If you gained U.S. Citizenship through Naturalization give certificate number, date, and location certificate was issued: | |
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If you gained U.S. Citizenship through your parents, did you obtain a certificate of citizenship in your own name? If yes give certificate number, date, and location certificate was issued:
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If you were previously a permanent resident did you gain your permanent residency through marriage to a U.S. Citizen or permanent resident? If yes, please explain:
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| Have you ever filed a petition for this or any other alien before? If yes, please explain: | |
Information About Father and Mother
| Family Name | First | Date, City/County of Birth | City/County of Residence | |
| Father | ||||
| Mother (Maiden) |
List Previous Husbands or Wives (if none state none)
| Family Name (if wife give maiden name) | First Name | Birth Date | Date and Place of Marriage | Date and Place of Termination of Marriage |
List Residence Last Five Years (start with most recent)
| Street Address (mo/yr) |
City | State/Province | Country | From (mo/yr) | To |
| Present | |||||
List Last Address Outside The United States of More Than One Year
| Street Address (mo/yr) |
City | State/Province | Country | From (mo/yr) | To |
List Employment Last Five Years (if none state none)
| Name of Employer (mo/yr) |
Address of Employer | Occupation | From (mo/yr) | To |
List Last Occupation Abroad (if none state none)
| Name of Employer (mo/yr) |
Address of Employer | Occupation | From | To |
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Immigration Law Group LLP 3590 N. First St., Suite 310 San Jose, CA 95134 Tel (408) 432-9200 Fax (408) 432-9191 www.immigrationlawgroup.net |