Immigration Client Information Sheet Date of Birth Law Offices Place of Birth United States employment based immigration law firm Pioneer Parkway Schedule Consultation Arlington Texas

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Immigration Client Information Sheet Date of Birth Law Offices Place of Birth United States employment based immigration law firm Pioneer Parkway Schedule Consultation Arlington Texas Powered By Docstoc
					MAIN OFFICE:                               Law Offices of                              SATELLITE OFFICE:
100 N. Central Expressway                                                             1700 E. Pioneer Parkway
Suite 1310 (Penthouse)         KENNETH G. WINCORN & ASSOCIATES, P.C.                                  Suite 240
Richardson, Texas 75080                                                                Arlington, Texas 76010
TEL.: (214) 630-1221                                                                       TEL: (817) 795-0202
FAX: (214) 630-2155                 Attorneys and Counselors At Law                       FAX: (817) 795-0303
E-MAIL: kwincorn@wincorn.com                                                   E-MAIL: kwincorn@wincorn.com



    Employment-based Immigration Client Information Sheet
Date (Fecha): ____________ Referred by (Referido Por): ____________________________

Part I: Personal information (Informacion Personal)
Name (Nombre):_____________________________________                     A#:______________________
Address (Domicilio): __________________________________________________
City (Ciudad):_________________State (Estado):________Zip Code (Código Postal): ___________
Tel: Home (Casa):______________ Wk. (Trabajo):_____________Cell (Celular): ______________
E-mail (Correo Electrónico):_____________________________
DOB (Fecha de Nacimiento)___________ Country of Citizenship (Ciudadania): ____________ Marital
Status (Estado Civil): __Married (Casado) ___Divorced (Divorciado) __ Single (Soltero) __Widowed
(Viudo)
Name of Spouse (Nombre del Esposo/a): __________________________________________________
Children’s Names & Ages (Nombres y Edades de los Hijos):
________________________________________________________________________________
Part II: Immigration information
Reason for appointmen (Razon por su visita): ___________________________________________
Employer (Nombre del Empleador): _____________________________________________________
Employer Phone No. & Address (Teléfono y Dirección del Patrón): _____________________________
_______________________________________________________________________________
Occupation (Ocupación):______________________
Current Immigration Status (Posición de Inmigración Actual): _______________________________
Date of last entry (Fecha de Entrada): _________ Visa type at last entry (Visa a la Entrada): ________
Pending USCIS Applications (Aplicaciones Pendientes de USCIS) _____________________________
If Resident, How Obtained? (Si es Residente, ¿Cómo lo Obtuvo?)______________________________
Previous Immigration Violations (Violaciones Anteriores de la Inmigración):_____________________
Criminal record (Antecedentes Penales):________________________________________________
DISCUSSIONS:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
______________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
______________________________________________________________________



Fees & Costs:
Legal Fees: __________Nonrefundable Retainer: ___________ Paid Today: __________Cash/Check

Balance of Legal Fees & Due Date: ________________________________________________________

Filing Fees: ____________Other Expenses: _______________Paid Today: ___________Cash/Check

Balance Filing Fees & Due Date: __________________________TOTAL PAID TODAY: ___________

Approved/Accepted by:___________________________Date: _________________________