B
O
C
BOGLE & CHANG, LLC
Phone: (800) 342-1733 Fax: (617) 674-2396
Email to: lawyer@immigrationlegalteam.com
CONSULTATION QUESTIONAIRE **(PLEASE PRINT)**
Information about the individual attending the consultation:
Date:___________________________________
Full Name:_______________________________________________________ Date of Birth: ______________
Address:__________________________________________________________________________________
(Street) (Apt. #) (City) (State) (Zip)
Phone (work):_____________Phone (home):_____________
E-mail address: _____________________________
Fax (home):_______________________Fax (work): _______________________
Referred to BOGLE & CHANG, LLC by: ________________________________
Brief description of the factual situation leading you to seek a consultation from BOGLE & CHANG:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Information from the Foreign National: (If person attending the consultation is not the foreign national, please complete the information that you
know concerning the foreign national who is the subject of the consultation)
Is the foreign national in the U.S.? ________ If so, last date of entry to U.S: _____________________________
Status at time of entry:_____________________(Tourist, Student, Without inspection, etc.)
Expiration date of I-94______________________________________
Immigration Number (As contained on foreign national’s work card, green card or any documents for the UCIS or Court) A#:_____________________________
Social Security Number (if any):_____________________________________________________________________
Other names used:_____________________________________________________________________
Foreign national’s place of birth (city/state/Country):___________________________________________________
Any right to citizenship in country other than country of birth: Yes____ No____
Is the foreign national employed by a U.S. employer? Yes____ No____
If so, name and address of U.S. Employer:
_________________________________________________________________________
_________________________________________________________________________
Please provide the foreign national’s prior periods of stay in the United States and type of visa:
(From) (To) (Type )
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Has the foreign national ever stayed beyond the date on the I-94 Arrival/Departure record?:________________
Has the foreign national ever worked without Citizenship and Immigration Service Permission?: ______________
Marital Status of foreign national (circle one): Single____ Married____ Divorced ____Widowed ____ Civil Union ____
Spouse's Name:____________________________________________
(Husband or Wife, also give maiden name for wife)
Date of Marriage:______________________
Place of Marriage:_________________________________________
(City, State, Province, Country)
Spouse's Status in the U.S.:__________________________________
Location of Spouse:________________________________________
If spouse is not a U.S. citizen, please provide all prior periods of stay in the United States by spouse of foreign national and type of visa:
(From) (To) (Type )
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
List children with Date, Place of birth (City, State, Country) & current immigration status if in U.S.:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Provide all prior periods of stay in the United States by children and type of visa:
(From) (To) (Type )
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
(Any children born in U.S.? If so, please indicate.)
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Does the Foreign National have any U.S. Citizen parents or grandparents? Yes____ No
Please provide details if known:
_________________________________________________________________________
_________________________________________________________________________
Has the foreign national ever appeared before an Immigration Judge?: Yes___ No ___
When:____________ Where:________________________
Result:_______________________
Attorney on case:______________________________
Phone:______________________________
Previous applications made to USCIS (formerly INS): _________________________________________________________________________
_________________________________________________________________________
Is the foreign national afraid to return to his/her country of Citizenship/Nationality? Why?
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Please list any arrests, charges and/or convictions including traffic violations: _________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Has the foreign national ever been fingerprinted for any reason, whatsoever?______________
For Yes, Explain circumstances__________________________________________________________________
When _______________________
Where__________________________________________________________________
_______________________________________________________________________
Why______________________________________________________________________
________________________________________________________________
_________________________________________________________________________
________________________________________________________________
_________________________________________________________________________
I understand that providing this information to BOGLE & CHANG, LLC is for
the purpose of obtaining a consultation and is not intended for the
purpose of establishing an attorney client relationship until I have executed
a written legal services agreement entering into such a relationship
with the BOGLE & CHANG, LLC.
Completed By:________________________________________________________
Signature ___________________________________________________________
PRINT NAME ________________________________________________________
DATE: ________________________________________________________
Phone: (800) 342-1733 Fax: (617) 674-2396
Email to: lawyer@immigrationlegalteam.com
CONSULTATION QUESTIONAIRE **(PLEASE PRINT)**
Information about the individual attending the consultation:
Date:___________________________________
Full Name:_______________________________________________________ Date of Birth: ______________
Address:__________________________________________________________________________________
(Street) (Apt. #) (City) (State) (Zip)
Phone (work):_____________Phone (home):_____________
E-mail address: _____________________________
Fax (home):_______________________Fax (work): _______________________
Referred to BOGLE & CHANG, LLC by: ________________________________
Brief description of the factual situation leading you to seek a consultation from BOGLE & CHANG:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Information from the Foreign National: (If person attending the consultation is not the foreign national, please complete the information that you
know concerning the foreign national who is the subject of the consultation)
Is the foreign national in the U.S.? ________ If so, last date of entry to U.S: _____________________________
Status at time of entry:_____________________(Tourist, Student, Without inspection, etc.)
Expiration date of I-94______________________________________
Immigration Number (As contained on foreign national’s work card, green card or any documents for the UCIS or Court) A#:_____________________________
Social Security Number (if any):_____________________________________________________________________
Other names used:_____________________________________________________________________
Foreign national’s place of birth (city/state/Country):___________________________________________________
Any right to citizenship in country other than country of birth: Yes____ No____
Is the foreign national employed by a U.S. employer? Yes____ No____
If so, name and address of U.S. Employer:
_________________________________________________________________________
_________________________________________________________________________
Please provide the foreign national’s prior periods of stay in the United States and type of visa:
(From) (To) (Type )
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Has the foreign national ever stayed beyond the date on the I-94 Arrival/Departure record?:________________
Has the foreign national ever worked without Citizenship and Immigration Service Permission?: ______________
Marital Status of foreign national (circle one): Single____ Married____ Divorced ____Widowed ____ Civil Union ____
Spouse's Name:____________________________________________
(Husband or Wife, also give maiden name for wife)
Date of Marriage:______________________
Place of Marriage:_________________________________________
(City, State, Province, Country)
Spouse's Status in the U.S.:__________________________________
Location of Spouse:________________________________________
If spouse is not a U.S. citizen, please provide all prior periods of stay in the United States by spouse of foreign national and type of visa:
(From) (To) (Type )
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
List children with Date, Place of birth (City, State, Country) & current immigration status if in U.S.:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Provide all prior periods of stay in the United States by children and type of visa:
(From) (To) (Type )
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
(Any children born in U.S.? If so, please indicate.)
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Does the Foreign National have any U.S. Citizen parents or grandparents? Yes____ No
Please provide details if known:
_________________________________________________________________________
_________________________________________________________________________
Has the foreign national ever appeared before an Immigration Judge?: Yes___ No ___
When:____________ Where:________________________
Result:_______________________
Attorney on case:______________________________
Phone:______________________________
Previous applications made to USCIS (formerly INS): _________________________________________________________________________
_________________________________________________________________________
Is the foreign national afraid to return to his/her country of Citizenship/Nationality? Why?
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Please list any arrests, charges and/or convictions including traffic violations: _________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Has the foreign national ever been fingerprinted for any reason, whatsoever?______________
For Yes, Explain circumstances__________________________________________________________________
When _______________________
Where__________________________________________________________________
_______________________________________________________________________
Why______________________________________________________________________
________________________________________________________________
_________________________________________________________________________
________________________________________________________________
_________________________________________________________________________
I understand that providing this information to BOGLE & CHANG, LLC is for
the purpose of obtaining a consultation and is not intended for the
purpose of establishing an attorney client relationship until I have executed
a written legal services agreement entering into such a relationship
with the BOGLE & CHANG, LLC.
Completed By:________________________________________________________
Signature ___________________________________________________________
PRINT NAME ________________________________________________________
DATE: ________________________________________________________
BOGLE
OKOYE
CHANG
Consultation Questionaire
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| BOGLE CHANG |
