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

TO BE COMPLETED BY THE PETITIONER

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 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 ever being able to return to the United States.
   

1. What is the relationship between you and the beneficiary of this petition?

 

  

2. Are you related by adoption?

   

3. Did you gain permanent residency through adoption?

 

Personal Information

 

4. Full Name

 

a. Family name

 b. First name

c. Middle name

 

 

 

5. Current address:

 

   a. Street  number

   b. City

   c. State/Province

   d. Zip code

   e. Country

   f.  Telephone

 

 
6. Place of Birth  
   a. City
   b. State (Province)
   c. Country
7. Date of Birth month/day/year
8. Gender
9. Marital status

 

 

10. Other name(s) used:

   a. Maiden name

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

 

 11. Information about the current marriage

 

   a. Date of marriage month/day/year

   b. City of marriage

   c. Country of marriage

 

 
12. Social Security Number
13. Alien Number (A#)

 

14. Information about prior marriage(s)

 

  a. Family name

b. First name

c. Date of divorce d. Date of death
 

 

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

   
2.    
3.    
4.    
5.    
         

If you had more than 5 prior marriages, use the space below.

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

 

15. Are you a U.S. Citizen?    If yes, please select one of the following:

 

 

16. Are you a U.S. permanent resident?     If yes, please give the following:

     a. Date of admission as a permanent resident month/day/year

     b. Place of admission as a permanent resident City/State

     c. Class of admission as a permanent resident 

 

17. Did you gain permanent residence status through marriage with a U.S. citizen or permanent resident?

 

 

18. Indicate the last address at which you lived together with the intending immigrant (the beneficiary of the petition):

      a. Street  number

      b. City

      c. State/Province

      d. Zip code

      e. Country

      f.  From month/year
      g. Until month/year

 

 

19. Are you filing separate petitions for other relatives?     If yes, please indicate the following:

  a. Family Name b. First Name c. Relationship to you
1.

2.
3.
4.
5.

 

 

20. Have you ever filed a petition for this or any other alien before?  If yes, please give the following:

  a. Family Name b. First Name c. Place where you filed d. Date of filing e. Results
City/State month/day/year
1.

 
2.

 
3.

 
4.

 
5.

 

 

  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Documents necessary for filing the I-130 Petition with the U.S. Department of Homeland Security:
* $190.00 – I-130 filing fee;
   
* Copies of personal documents:  birth certificates, marriage certificate, divorce decree(s); death certificate(s) (for both the petitioner and the beneficiary)
 
   
* Copies of passport, visa(s) and I-94 (for the beneficiary)
   
* Two passport style identical pictures (for each, the petitioner and the beneficiary)
   
* If this is a marriage based application, we need a Personal Statement from you.  Plea