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 Name Last Name
Birth Date

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

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

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

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

Yes No
If you are male who qualified, did you meet the Selective Service Requirements?

Yes No
Are you in removal proceedings?
Have you ever committed any crimes anywhere in the world?

Yes No
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?

Yes No
If filing based on marriage, have you been residing in the US the last 1.5 of the last 3 years?

Yes No
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?

Yes No
Type a question

SNAP Temporary Assistance for Needy Family (TANF) Section 8 Housing Medicare Supplemental Security Income Other
If other, Explain:
Previous Relationships
Are you married?

Yes No
Have you had prior marriages

Yes No
Taxes
Have you always filed US taxes since legally working or residing in the US?

Yes No
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?

Yes No, thank you.
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Should be Empty:

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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