3 4 5 9  Lawrenceville - Suwanee  Rd., Suite A,  Suwanee ,  Georgia

Tel: (770) 271-5244 ● Toll Free:  (888) 768-7252 ● Fax: (770) 271-5604 ● Cornel@PotraLawFirm.com ● www.potralawfirm.com

Attorneys:  Cornel Potra – Admitted: Georgia & Washington  ●  Kristina F Potra – Admitted: Georgia

This questionnaire is for the exclusive use of Potra Law Firm.  Please answer all the questions.  Do not leave any questions unanswered.  If you do not have an answer to a question, please insert “N/A”.  It is your responsibility to provide true and accurate information, as well as the evidentiary documents requested

This Document Is For The Attorney’s Office Use Only

 

  

QUESTIONNAIRE I-130

THE BENEFICIARY

Please understand that our firm will NEVER file a fraudulent application.  If you are either the Petitioner or the Beneficiary of this Petition, and your Petition is marriage-based, you MUST make sure your marriage is bona fide (based on love and mutual consent to a life-long relationship).  Although I do not have the means to thoroughly investigate your personal lives, I will ask certain questions to convince myself that your marriage is bona fide.  It is illegal and punishable by law to lie or present misleading information or false documents.  Your falsehood in providing untruthful information or fraudulent documents may lead to your deportation from the United States.  Should the Immigration Department or the Immigration Court find sham marriage, your deportation is certain and you will be barred forever from being able to return to the United States.
 

Personal Information

 

1. Full Name

a. Family name

 b. First name

c. Middle name

 

2. Current address:

 

   a. Street  number

   b. City

   c. State/Province

   d. Zip code

   e. Country

 
 
3. Place of Birth  
   a. City
   b. State (Province)
   c. Country
4. Date of Birth month/day/year
5. Gender
6. Marital status
   

 

 

 

7. Other name(s) used:

   a. Maiden name

   b. Name(s) used from prior marriage(s)

 

 8. Information about the current marriage

 

   a. Date of marriage month/day/year

   b. City of marriage

   c. Country of marriage

 

If it applies, please mention

 

9. Social Security Number
10. Alien Number (A#)

 

11. Information about prior spouse(s)

 

  a. Family name

b. First name

c. Date of divorce d. Date of decease
 

 

 month/day/year month/day/year
1.

   
2.    
3.    
4.    
5.    
         

If you were married more than five times, use the space below.

It is very important to respect the order of the information requested.

 

12. Are you in  U.S. at the time this application is filed?  If yes, please give the following:

   a. Type of visa  
   b. I-94 Number
   c. Date of arrival in the U.S. month/day/year
   d. I-94 expiration date month/day/year
   

 13. Information about current employment

 

 

   a. Employer's name (company name)
   b. Employer's address  
       Street number
       City
       State
       Zip Code
       Country
   c. Date  when employment began

         month/day/year

 

 14. Have you ever been under immigration proceedings?    If yes, please give the following:

   a. Place

   b. Date month/day/year

   c. Type of proceeding

 

15. Information about your spouse

 

   a. Family Name (maiden name for females)

   b. First Name

   c. Middle Name

   d. Date of Birth month/day/year