IMMIGRATION CONSULTATION QUESTIONNAIRE

 
Persons who need legal advice or legal representation from Potra Law Firm may wish to schedule an over-the-phone interview with attorney Cornel Potra or any other Potra Law Firm staff. 

Before an interview is scheduled, we request that you completely fill out the Immigration Consultation Questionnaire and send it to our office by clicking on the "Send Questionnaire" button at the bottom of this page. 

Please include information related to the person who is seeking a temporary/permanent visa, citizenship, green card, deportation relief or any other immigration benefit. The filled out questionnaire should contain information pertinent to the person who seeks immigration relief, or, if the person is an employer offering employment to an immigrant (Labor Certification), he/she should complete the questionnaire separately from the immigrant. The immigrant himself/herself should complete a questionnaire separately. You may choose to fax this questionnaire along with any other supporting documents pertinent to your situation at the following fax number: (770) 271-5604. 

Following the submission or the faxing of this questionnaire, please call our office during the business hours of 9:00am through 5:00pm E.T. to set up an appointment to talk with attorney Potra. Our office takes appointments every thirty minutes. The cost of a thirty minutes over-the-phone immigration consultation is $100.00. A minimum time slot is thirty minutes. If you retain Potra Law Firm to represent you on the day of the consultation, we will credit the entire consultation fee toward your final bill. Please call: (770) 271-5244.

A consultation with an attorney of Potra Law Firm does not establish an attorney-client relationship! 

The information provided in the Questionnaire will be kept strictly confidential. We will not release it without your permission.

 
BASIC INFORMATION
 Last Name:
 		First Name:
 		Middle Name:
Other names used (including maiden name):
 
Address:
City:
State:        Zip:

Country:
E-mail Address:
Home Phone:  Work Phone: 
Hours we can call:  Hours we can call: 
Social Security No:  Citizen of: 
Date of Birth:  Country of Birth: 
Passport Number:  Date your passport expires: 
 
What type of immigration assistance are you seeking?
 
FAMILY INFORMATION
Husband or Wife               ( Check if Not Applicable)

Name:

Current Address (put "same" if you live together):

Date of Birth:

Place of Birth:

Date of Marriage:

Place of Marriage:
    
Children
Total Number of Sons and Daughters:
Name Sex Date of Birth Place of Birth Citizen of
 
Parents
Name Date of Birth Place of Birth Citizen of Resident of
Your
Father:
Your
Mother:
Spouse's
Father:
Spouse's
Mother:

Past Marriages               ( Check if Not Applicable)
Name Nationality Date of
Marriage		 Place of Marriage Kids? Date of 
Divorce/Death
Your:
Spouse's:
 
IMMIGRATION HISTORY
 
Current Immigration Status:  Date Status Expires:
I-94 Number: Total Entries into U.S.:
Date of First Entry into U.S.:  Last Entry into U.S.: 
 
Check every type of immigration status that you have ever held and provide the dates:
Immigration Status Date(s) Immigration Status Date(s)
B Visitor: E Trader/Investor:
F Student: H-1B Professional:
J Exchange Visitor: K Fiancee:
L Manager: O Outstanding Ability:
P Performer/Athlete: R Religious Worker:
T/N Canadian Worker: Other:
 
Check each one that you or your spouse have ever applied for or been the beneficiary of:
Y(you) or
S(Spouse)		 Date Filed Sponsor Attorney Result
Green Card
Immigrant petition
Labor certification
Asylum
Amnesty
 
Have you or your spouse ever had any immigration problems? In particular, have you or your spouse ever been under deportation, rescission, or exclusion proceedings? Please describe in detail:
 
EMPLOYMENT HISTORY
Current Employment

Employer:

Address:

Position:

Salary:

Duration:

Are you related to your employer?

May we contact your employer? 

   

If yes, whom may we contact:
Name Title Department Phone Number
 
Employment in Last Five Years (anywhere in the world)
Position Employer City/Country Start & End Dates