Intake Sheet Online | Scott and Associates

Intake Sheet: US Citizen Spouse Petitioner

Alien's information

Alien's Last Name(s): *

First Name: *

Date of Birth: *

Petitioner's information

Petitioner's Last Name(s): *

First Name: *

Date of Birth: *

date of marriage:

place of marriage:

Contact information

email (list ONE): *

email a copy of this form when complete?: *

Yes

US phone (for leaving messages): *

US mailing address (street address, city, state, and zip code): *

Citizenship

Alien's countries of citizenship and lawful permanent residence (list all): *

Is the petitioner a citizen or lawful permanent resident (LPR) of any country other than the US?: *

Yes

If yes, what country or countries:

Basic Info

How far along are you in the process (check only one)?: *

Not sure/ Not applicable

Nothing has been filed

The petition (I-130) is pending

The petition is approved, but NVC processing is not done

Done NVC processing & awaiting interview

The consular interview has taken place

The I-601 (and/or I-212) is pending

The I-601 (and/or I-212) has been denied

Date and Signature

Re-enter the Alien's last name as given in the first question: *

I attest (a) that the above is true to the best of my knowledge, (b) that the Alien has not entered or exited the country except as listed on this form, (c) that the Alien has not been arrested except as listed on this form, (d) that if I discover that the Alien has entries or exits not listed above or arrests not listed above, that I will immediately inform the attorney in writing, and (e) that by entering my name below I am signing this document.

Name of person completing the Intake Sheet: *

Signature date: *