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 Immigration Consultation Questionnaire

You may fill out this form and submit it to us online, if your web browser supports online forms. If not, or if you prefer not to submit this information over the Internet for confidentiality reasons, you may print out this questionnaire and fax or mail it to us. Please note that information submitted to us over the Internet may not be 100% secure while it is in transit. If this concerns you, please fax or mail the form to us instead of using this online form. Please see the bottom of this form for fax number and mailing address.

Once we receive your completed questionnaire we will contact you to schedule your consultation. The fee for an immigration consultation is $225. You may pay by check (payable to Miller Mayer) or by Visa or MasterCard. You must pay before or at the consultation. The consultation fee may be credited toward any flat fee that we agree to for subsequent work done on your behalf, depending on the nature of your case.

Intro

Please note and agree to the following: At this time I have not yet decided to retain the legal services of Miller Mayer nor has Miller Mayer decided to accept my case. Miller Mayer is under no obligation to represent any of the parties mentioned in this questionnaire. Our advice to you can only be based on the facts you give us. We are not liable for failing to give proper advice when we do not know all the facts.

Your full name:
Today's date: 
I agree I don't agree.

(If you do not agree to the above, please do not submit this form to us.)

What would you like us to do for you?

Present Address

Permanent address outside U.S.:

1. Phone, Fax, E-mail
Work Phone #:
Home Phone#:
Fax:
E-mail
2. Birth
Birthdate (month, day, year):
Country of Birth:
3.Citizenship
Present citizenship or nationality(ies): 
4. Visa history
If you are in the U.S. now
On what visa did you enter:
What is your current immigration status:
If you are not in the U.S. now
Have you obtained a U.S. visa and/or travelled to the U.S. before: Yes    No
If yes, on what type of visa:
5. Immigration Status
Status expiration date:
Visa expiration date: 
6.
Have you ever stayed in the U.S. beyond the time you were authorized to stay?
Yes No
If yes, explain the circumstances:


Have you ever applied for a U.S. visa, either immigrant or non-immigrant, which application was denied?
Yes No
If yes, explain the circumstances:
7. Marital Status
Single Married Separated Divorced Widowed
If your spouse has immigration possibilities separate from your own, please describe:
8.
Please list your children (if any are step-children or children by another spouse, indicate which and give further details in the box):
 
9.
Please list your education and training. Please provide the following: names and addresses of schools, main field of study, dates attended, and degrees or certificates received, or e-mail or fax us your resume. Our e-mail address and fax number are at the end of this form:
 
10.
If you are seeking a visa based on a job, please tell us the name and address of the employer, your job title and job duties:
11.Personal background (for purposes of qualifying for immigration).
Have you ever had any problem before with U.S. immigration or police authorities? Have you ever been arrested or fingerprinted for any reason, even if never charged with a crime? If so, please describe:
Please tell us anything else you think might be relevant to your situation (e.g. other job offer, fear of persecution, any relatives who are or were US citizens etc.):
12.
Have you consulted, or are you currently consulting other immigration lawyers? If so, who and about what:
13.
If you have previously spoken with one of our immigration lawyers, please tell us who and if you would like that lawyer to assist you again:
14.
How did you hear about us? If from the Internet, what search engine did you use:



The contents of these web pages are provided for general informational purposes and do not constitute legal advice for specific cases, which should only be obtained from an attorney.
Copyright © 2008 Miller Mayer. Attorneys at Law
The Commons, 202 East State Street, Ithaca, New York 14850

phone: 607-273-4200, fax: 607-272-6694, E-mail: info@millermayer.com