Immigration Client Intake Form - Sommers Ulloa Attorneys at Law

The purpose of an initial consultation is for the attorney to advise you, the prospective client, what, if anything, may be done for you, and what the minimum fee will be. The purpose is not to render a definitive legal opinion, as it may be impossible to fully assess a matter within the time frame allotted for a consultation or with the information or documents
that you provided to the attorney at the initial consultation.

NOTE : The following questions will help us to understand the purpose of your visit today. Your responses are protected by attorney/client privilege and will be held in the strictest confidence. Please note, if you brought or sent documents to the attorney that are related to your legal matter, those documents will be scanned, with your permission, and your originals returned to you at the conclusion of the initial interview.

I. BACKGROUND INFORMATION

Name *

First

Middle

Last

All Other Names Used / Aliases:

Current Address

Address Line 1

City

State

Zip Code

Layout

Home Phone

Work Phone

Date of Birth

Cell Phone Number

Email Address *

II. REFERRAL

How Did You Learn Of Our Office?

III. PURPOSE FOR MEETING WITH ATTORNEY

Briefly explain what immigration advice you need today and what legal assistance we can assist you with:

Are we the first attorneys you have consulted regarding your immigration matter?

Yes
No

Have you ever been represented by an attorney before?

Yes
No

IV. IMMIGRATION HISTORY

Layout

Permanent Immigration Status

Alien ("A") Number

Date Status Expires

Visa Number

Date and Place of First Entry into U.S.

Date and Place of Last Entry into U.S.

I-94 Number and Expiration Date

Name Exactly as it Appears on I-94 Card

Layout

Consulate that Issued Visa

Passport Number

Please list ALL non-immigrant visas that you have ever held and provide the dates you held that status:

Layout

VISA

VISA 1

VISA 2

VISA 3

Date From

VISA From Date 1

VISA From Date 2

VISA From Date 3

Date To

VISA To Date 1

VISA To Date 2

VISA To Date 3

V. SPOUSAL INFORMATION

Spouse's Name *

First

Middle

Last

Spouse (Please Check One)

In U.S.
Outside the U.S.
Unmarried

Other Names Used (Maiden Name)

Current Address

Address Line 1

Address Line 2

City

State

Zip Code

Date and Place of Birth of Spouse

Country Citizenship

Alien (“A”) Number

Current Immigration Status

Expiration Date

VI. PARENT’S INFORMATION

Layout

Father Full Name

Father City / Country of Birth

Father Current Residence

Father Alien (“A”) Number

Father Ever Been to United States?

Mother Full Name

Mother City / Country of Birth

Mother Current Residence

Mother Alien (“A”) Number

Mother Ever Been to United States?

VII. EMPLOYMENT HISTORY

CURRENT EMPLOYER (OR EMPLOYER PETITIONING ON YOUR BEHALF) :

Employer

Address

Job Title

Date of Hire

Salary

Are you related to your employer (Please Check)?

Yes
No

May we contact your employer (Please Check)?

Yes
No

VIII. ALTERNATIVE CONTACT INFORMATION

If your mail is returned as undeliverable or telephone service terminated, please provide the name of someone (friend or relative) you believe will always know how to contact you and whom you authorize us to contact.

Layout

Name

Relationship

Address

Address Line 1

City

State

Zip Code

Layout

Phone No.

Cell Phone

IX. PLEASE READ CAREFULLY & SIGN BELOW

If you complete this intake sheet prior to your consultation with Attorney and your legal problem(s) involves a pending deadline, response or an upcoming hearing that is due prior to your consultation with Attorney, you are strongly urged to notify Attorney of this in writing. If the Attorney cannot meet with you prior to your deadline or response, you are advised to immediately consult with another attorney to protect your legal rights.

Following your initial interview, if you agree to retain the Attorney, and the Attorney agrees to represent you, you will both sign an Agreement for Representation. The Agreement for Representation will set forth the terms and conditions of representation.

If the Attorney is willing to represent you and you decide not to sign an Agreement for Representation today, you are strongly urged to schedule a second appointment with the Attorney at the earliest possible time or to consult immediately with other legal counsel to protect your rights.

NOTICE: THIS OFFICE DOES NOT REPRESENT YOU WITH REGARD TO THE MATTERS SET FORTH BY YOU HEREIN OR DISCUSSED DURING YOUR CONSULTATION UNLESS AND UNTIL BOTH YOU AND THE ATTORNEY EXECUTE A WRITTEN RETAINER AGREEMENT FOR REPRESENTATION AND YOU.

Your signature below acknowledges ONLY that you have read and understand the contents of this Client Intake Form or that you have had the contents of this Client Intake explained to you in your native language, and that the information you put forth in this Client Intake Form is true and correct to the best of your knowledge. Your signature below DOES NOT SIGNIFY that you have retained the Attorney or that the Attorney represents you on this or any other matter(s).

If the Attorney does not agree to represent you, this includes not representing you with regard to the matter(s) set forth by you on this Client Intake Form or any other matters you may discuss with the Attorney during your consultation, you are advised to immediately consult with another attorney to protect your rights. The Attorney’s decision not to represent you should not be taken by you as an expression regarding the merits of your case.

Layout

Signature (Type your name)

Date