Naturalization - Consultation Intake Form

Please fill out the form as best you can at least 30 minutes before the consultation.
Applicant's Information
Applicant's Full Name*

First NameLast Name
Birth Date

MonthDayYear
Country of Birth
List all citizenships
When did you become a legal permanent resident?*

MonthDayYear
How did you gain LPR status?
Contact Information
E-mail
Ex: myname@example.com
Phone Number*

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Skype
Background Information
Have you ever been detained by the police or immigration?
Have you ever served in the military?

YesNo
If you are male who qualified, did you meet the Selective Service Requirements?

YesNo
Are you in removal proceedings?
Have you ever committed any crimes anywhere in the world?

YesNo
If yes, explain briefly:
Have you ever made a false claim to US citizenship?
Have you ever committed any fraud to immigration?
Have you ever applied for asylum?
Have you ever applied for naturalization before? If so, when and what was the result?
How did you obtain your current legal permanent resident status? If from family, how did they obtain it?
Have you ever been refused entry into the US?
US Residency
Since becoming a LPR, have you been outside the US more than 6 months at a time?

YesNo
If filing based on marriage, have you been residing in the US the last 1.5 of the last 3 years?

YesNo
If filing based on receiving your LPR status not through marriage to a US citizen, have you been residing in the US the last 2.5 of the last 5 years?

YesNo
Type a question

SNAPTemporary Assistance for Needy Family (TANF)Section 8 HousingMedicareSupplemental Security IncomeOther
If other, Explain:
Previous Relationships
Are you married?

YesNo
Have you had prior marriages

YesNo
Taxes
Have you always filed US taxes since legally working or residing in the US?

YesNo
Conclusion
Overall goal of consult/ what is the main issue that needs to be resolved during consult?*
How did you hear about the law firm?*
Name of the person completing the intake sheet:
Date (MM-DD-YYYY)
Which location will your consultation take place?
How would you prefer your consultation?
Would you like to receive immigration updates through our Newsletter?

YesNo, thank you.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty:

Please fill out the form as best you can at least 30 minutes before the consultation.

Applicant's Information

Contact Information

Background Information

US Residency

Previous Relationships

Taxes

Conclusion