APPLICANT'S QUESTIONNAIRE FOR IMMEDIATE RELATIVE SPOUSE OF PERMANENT RESIDENT

Please type your answers into the right column. Use additional sheet(s) as required.

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GENERAL INFORMATION
Full Name (First/Middle/LAST):  
Other Names Used (Maiden):

  		 
Sex (Male or Female):

  		 
U.S. Address:  
Home Telephone:  
Office Telephone:  
Fax Number:  
Email Address:  
Date of Birth (mo/day/year):  
Place of Birth (City, State/Province, Country):  
U.S. Social Security Number (if any):  
Alien Registration Number (if any):  
Your Foreign Address and Phone Number Abroad:  
Date of Last Arrival:  
City and State of Last Entry:  
I-94 Number:  
Consulate Where Visa Was Issued:  
Date Visa Was Issued:  
 

List all of your children
Full Name Relationship Date and Place of Birth A Number
       
       
       
       
 

Information About Father and Mother

  Family Name First Date, City/County of Birth City/County of Residence
Father        
Mother (Maiden)        

List Previous Husbands or Wives (if none state none)

Family Name (if wife give maiden name) First Name Birth Date Date and Place of Marriage Date and Place of Termination of Marriage
         
         
         

List Residence Last Five Years (start with most recent)

Street Address
(mo/yr)		 City State/Province Country From (mo/yr) To
          Present
           
           
           
           
           
           
           

List Last Address Outside The United States of More Than One Year

Street Address
(mo/yr)		 City State/Province Country From (mo/yr) To
           

List Employment Last Five Years (if none state none)

Name of Employer
(mo/yr)		 Address of Employer Occupation From (mo/yr) To
         
         
         
         
         
         
         

List Last Occupation Abroad (if none state none)

Name of Employer
(mo/yr)		 Address of Employer Occupation From To
         




Immigration Law Group LLP
3590 N. First St., Suite 310
San Jose, CA 95134
Tel (408) 432-9200
Fax (408) 432-9191
www.immigrationlawgroup.net