Green Card Questionnaire

GREEN CARD QUESTIONNAIRE

GREEN CARD QUESTIONNAIRE

Your Full Name

First Name

Middle Name

Surname

2) Birth Day Of Your Mother

Month

Day

Year

Country Of Birth

City Of Birth

3) Birth Day Of Your Father

Month

Day

Year

Country Of Birth

City Of Birth

4) Maiden Name Of Your Mother

5) Your Mother's Full Name

First Name

Middle Name

Surname

6) Your Father's Full Name

First Name

Middle Name

Surname

7) Is Your Mother deceased

Yes

Country And City Of Residence Of Your Mother

City

Country

8) Is Your Father deceased

Yes

Country And City Of Residence Of Your Father

City

Country

9) Your Telephone Number

10) Your Email

11) All Names Used By You Including Your Prior Marriages

First Name

Middle Name

Surname

First Name

Middle Name

Surname

First Name

Middle Name

Surname

First Name

Middle Name

Surname

First Name

Middle Name

Surname

12) List your Current Address first , Month And Year Of ALL Place Of Residence For The Last 5 Years

Present Address

Apartment/building/Floor/Unit No

City

State

Zip Code

Country

Zip Code

Month Day Year Start

Present

Address 2

Address Line 1

Apartment/building/Floor/Unit No

City

State

Zip Code

Country

Month Day Year Start

Month Day Year Stop

Address 3

Address Line 1

Apartment/building/Floor/Unit No

City

State

Zip Code

Country

Month Day Year Start

Month Day Year Stop

Address 4

Address Line 1

Apartment/building/Floor/Unit No

City

State

Zip Code

Country

Month Day Year Start

Month Day Year Stop

Address 5

Address Line 1

Apartment/building/Floor/Unit No

City

State

Zip Code

Country

Month Day Year Start

Month Day Year Stop

Month

Day

Year

Month

Day

Year

Address 6

Address Line 1

Apartment/building/Floor/Unit No

City

State

Zip Code

Country

Month Day Year Start

Month Day Year Stop

Month

Day

Year

Month

Day

Year

13) List Full Name and Address Of Employer For The Last 5 Years, List Month And Years

Name of Employer 1)

PRESENT EMPLOYMENT COMPANY NAME

Present Employment Address

Apartment/building/Floor/Unit No

City

State

Zip Code

Country

Occupation

Month Day Year Start

Month Day Year Stop

Month

Day

Year

Month

Day

Year

Name of Employer 2)

Company name 2

Address Line 1

Apartment/building/Floor/Unit No

City

State

Zip Code

Country

Occupation

Month Day Year Start

Month Day Year Stop

Month

Day

Year

Month

Day

Year

Name of Employer 3)

Company name 3

Address Line 1

Apartment/building/Floor/Unit No

City

State

Zip Code

Country

Occupation

Month Day Year Start

Month Day Year Stop

Month

Day

Year

Month

Day

Year

Name of Employer 4)

Company name 4

Address Line 1

Apartment/building/Floor/Unit No

City

State

Zip Code

Country

Occupation

Month Day Year Start

Month Day Year Stop

Month

Day

Year

Month

Day

Year

Name of Employer 5)

Company name 5

Address Line 1

Apartment/building/Floor/Unit No

City

State

Zip Code

Country

Occupation

Month Day Year Start

Month Day Year Stop

Month

Day

Year

Month

Day

Year

Name of Employer 6)

Company name 6

Address Line 1

Apartment/building/Floor/Unit No

City

State

Zip Code

Country

Occupation

Month Day Year Start

Month Day Year Stop

Month

Day

Year

Month

Day

Year

Name of Employer 7)

Company name 7

Address Line 1

Apartment/building/Floor/Unit No

City

State

Zip Code

Country

Occupation

Month Day Year Start

Month Day Year Stop

Month

Day

Year

Month

Day

Year

14) Full Name of All Your Previous Spouses, Date Of Birth, Date Of Marriage, Place Of Marriage, Date Of Divorce/Death, Place Of Divorce

Full Name Spouse 1

First Name

Middle Name

Surname

Date Of Birth

Month

Day

Year

Date Of Marriage

Month

Day

Year

Place Of Marriage

Date Of Divorce/Death

Month

Day

Year

Place Of Divorce

Full Name Spouse 2

First Name

Middle Name

Surname

Date Of Birth

Month

Day

Year

Date Of Marriage

Month

Day

Year

Place Of Marriage

Date Of Divorce/Death

Month

Day

Year

Place Of Divorce

Full Name Spouse 3

First Name

Middle Name

Surname

Date Of Birth

Month

Day

Year

Date Of Marriage

Month

Day

Year

Place Of Marriage

Date Of Divorce/Death

Month

Day

Year

Place Of Divorce

Full Name Spouse 4

First Name

Middle Name

Surname

Date Of Birth

Month

Day

Year

Date Of Marriage

Month

Day

Year

Place Of Marriage

Date Of Divorce/Death

Month

Day

Year

Place Of Divorce

(#15-21 should be answered only if you are the Beneficiary)

15) Have you ever been in the United States

Yes

16) In What Status Did You Last Enter The U.S(Visitor, Student Exchange, Exchange Visitor, Crewman, and Temporary, Work Without Inspection ECT...)?

17) Were you inspected by An US Immigration Officer?

Yes

18) Your Passport Number

Expiration Date

Day

Year

19) Your VISA Number

20) Date Of VISA Issued

Month

Day

Year

21) Where was your VISA Issued

22) Full name of your present spouse

First Name

Middle Name

Surname

23) Date Of Birth of Your Present Spouse

Month

Day

Year

24) City and Country Of Birth Of Your Current Spouse

25) Is Your Spouse A U.S Citizen?

Yes

26) Your Spouse "A" Number

26) Your "A" Number

27) Your Social Security Number

28) Your Date Of Birth

Month

Day

Year

29) How many living children do you have? (answer this question only if you are the Beneficiary)

Names of ALL your children (answer this question only if you are the Beneficiary)

Full Name OF Child 1

Date Of Birth

Sex

Male

Female

Full Name OF Child 1

Date Of Birth

Sex

Male

Female

Full Name OF Child 2

Date Of Birth

Sex

Male

Female

Full Name OF Child 3

Date Of Birth

Sex

Male

Female

Full Name OF Child 4

Date Of Birth

Add child

First Name

Last Name

Sex

Male

Female

Full Name OF Child 5

Date Of Birth

Sex

Male

Female

Full Name OF Child 6

Date Of Birth

Sex

Male

Female

30) Immigration Status Of Your Present Spouse.

Text Input

31) Your place of last entry in the US

City

State

32) Have you ever been arrested or cited, if yes produces Evidence

Yes

Description

File Upload

Choose File

33) Have you even been in jail or prison

Yes

34) Did you ever join any army or police force

Yes

35) If yes how long

36) Have you ever been deported from the U.S

Yes

37) Have you registered with the selective services

Yes

38) How old were you when you received your green card

39) Were your parents married before your 18th birthday

Yes

40) Your country of citizenship

41) Is your mother a U.S citizen date:

Yes

When She Became Us Citizen Month

Day

Year

42) Is your father a U.S citizen date:

Yes

When He Became Us Citizen Month

Day

Year

43) Your Height

Feet

Inches

44) Your Weight ( In Pound )

45) What race are you

Black

White

Asian

American Indian Or Alaskan native

Native Hawaiian Other Pacific Islander

46) What is you Ethnicity

Latino

Not Latino

47) Eye Color

48) Hair Color

49) Your Country of birth

50) Your city of birth

51) Have you ever had any Police Or Military Training

Yes

52) How many times have you been married ( Including present marriage )

53) Date of last marriage

Month

Day

Year

(54-58 answer these questions only if you are the Beneficiary)

Date start living there

54) Your last address before you came to the USA. Give the date you start living at this address.

Month you start living at this address

Day you start living at this address

Year you start living at this address

55) Date of last entry in the USA

Month

Day

Year

56) Place of the last entry in the USA (city and state)

57) The name and address of last employment before you came to the USA

Company Name:

Company Address:

Occupation:

Date start working:

Date stop working:

(THIS QUESTION IS FOR THE BENEFICIARY)

58) Have anyone filed for you before

Yes

Name Of Person

First Name

Middle Name

Surname

The Outcome Of The Filing

(THIS QUESTION IS FOR THE PETITIONER)

59) Have You Filed For Anyone Before

Yes

Name Of Person

First Name

Middle Name

Surname

Date Of Filing

Place Of Filing

City

State

The Result

ADD NOTES

First Name

Last Name

COMMITTED TO ASSISTING

THE JOURNEY

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Green Card Questionnaire

GREEN CARD QUESTIONNAIRE

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