Safe Havens

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Appendix F. Basic Immigration Status Questionnaire

 
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Basic Immigration Status Questionnaire

 


Purpose: To obtain the facts necessary for an immigration lawyer to determine immigration consequences of a criminal conviction. 


 


Documents: Xerox any immigration documents/passport.


 


Criminal History: Rap sheets and possible current plea-bargain offenses needed before calling.


_____________________________       ________________           


Client's Name                                              Date of Interview   


 


Immigration Hold:  YES    NO


 


___________________________    (_____)____________              ______________


Client's Immigration Lawyer          Telephone Number         Def's DOBirth


 


1.  Entry: Date first entered U.S.? ________________Visa Type:_____________


     Significant departures: Date: _________________  Length: ______________


     Purpose: _________________


     Date last entered U.S.?  _______________   Visa Type: __________________


 


2.  Immigration Status: Lawful permanent resident?  YES     NO


     If so, date client obtained green card?  _______________


 


     Other special immigration status: (refugee), (asylee), (temp. resident),


 (work permit), (TPS), (Family Unity), (ABC), (undocumented),


 (visa - type:________________) Date obtained? _____________


 


 Did anyone ever file a visa petition for you?  YES NO


 Name and #:________________________________  Date? ____________


 Type of visa petition? __________________  Was it granted? YES        NO


 


3.  Prior Deportations: Ever been deported or gone before an immigration judge?  YES  NO    Date? _____________________________________


      Reason? ______________________________________________________


 


Do you have an immigration court date pending? YES                   NO


Reason? _______________________________  Date?__________________________________


 


4.  Prior Immigration Relief:  Ever before received a waiver of deportability [§ 212(c) relief or cancellation of removal] or suspension of deportation?  YES       NO     


      Which:______________          Date: ____________


 


5.  Relatives with Status: Do you have a U.S. citizen relative: (parent), (spouse), (child -- DOB(s) _________________________________), (brother) or (sister)? 


Do you have a lawful permanent resident (spouse) or (parent)?  ________________________________________________________


 


6.  Employment: Would your employer help you immigrate? YES    NO


Occupation:______________________


Employer's name and number:____________________________________


 


7.  Possible Unknown U.S. Citizenship: Were your or your spouse's parent or grandparent born in the U.S. or granted U.S. citizenship?  YES           NO  Were you a permanent resident under the age of 18 when a parent naturalized to U.S. citizenship?         YES    NO


 


8.  Have you been abused by your spouse or parents?           YES    NO


 


9.      In what country were you born?  _________________


      Would you have any fear about returning?   YES                NO


      Why? ___________________________________________________


 


 

 

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