Attorney Alexander Ivakhnenko

Home     About the Practice     Biography     Federal Crimes     State Crimes     Immigration Law     Links to Legal Resources     Contact      
Asylum     Adjustment of Status     Immigration Assistance     Naturalization     Intake Form      

Please fill out the following form below prior to an immigration consultation and e-mail to the address.

This information will be helpful  to better examine your particular immigration issue.   

Law offices of Alexander Ivakhnenko, Esq.

773-562-8602

depaul2005@yahoo.com

 

INTERVIEW INTAKE QUESTIONNAIRE

 

1. Name _______________________________________________________________________________

               Last Name First name Middle Name (Patronymic)

 

a. Other names ever used __________________________________________________________________

                                              Maiden Name Alias

2. Birth Place ___________________________________________________________________________

                        Location                                                         Date

 

3. US. Address ________________________________________________________________________ 

                           Street No. and Name City, State Zip code

 

a. Foreign Address if any _________________________________________________________________

                                              Street No.                                        Name City                     State                  Zip Code              Country

 

4. Telephone ___________________________________________________________________________

  

5. Nationality __________________________________________________________________________

                           Current Citizenship if any

 

6. Entry in the United States _______________________________________________________________

                                                     Place                                                Date                                              Type of Entry Visa

 

7. Visa Status __________________________________________________________________________

                            Visa Type                                 Date of Issuance                       Place of Visa Issuance                      Visa expiration date

 

9. Alien Registration Number if any _________________________________________________________

                                                              Date of Issuance

 

10. Social Security Number ________________________________________________________________

                                                 Date of Issuance                                                      Place of issuance

 

 

11. Name, Date, Place of Birth of spouse and children if any ________________________________________

 

______________________________________________________________________________________

 

 

12. List Permanent Resident or U.S. citizen relatives in the U.S. with address and telephone number

 

_______________________________________________________________________________________

 

 

13. List name, address, and telephone number of person who referred you to the law firm

 

_______________________________________________________________________________________

 

 

14. List name, address, and telephone number of the attorney who consulted or worked on your immigration issue

 

___________________________________________________________________________

 

 

15. List the status of your case filed personally or by someone on your behalf if you know

 

______________________________________________________________________________________

 

 

Date _________________

 

Signature of alien or person providng the information  and her relationship to the alien

 

_________________________________________________________________ 

 


 

 download the intake form