Eng & Nishimura

Helping US businesses compete globally
Helping immigrants achieve the American dream

Initial Intake Questionnaire

Please complete as much of the form as possible, as doing so will enable us to better advise you of your options.

Your Immigration Goals
What are your immigration goals:
Your Biographical Information
First Name: Middle Name: Last Name:
Other Names Used:
Sex:
Birth Date:  ,  City/State of Birth: Country of Birth:
Current Address
Street Address:
City: State: Zip/Postal Code:
Country: Email Address:
Home Phone: Cell Phone: Work Phone:
Current or Last Address Outside the US
Street Address:
City: State: Zip/Postal Code:
Country:
Your Spouse
First Name: Middle Name: Last (Maiden) Name:
Other Names Used:
Sex:
Birth Date:  ,  City/State of Birth: Country of Birth:
Citizen Of: Immigration Status: Status Expires:  , 
Current Address:
City: State: Zip/Postal Code:
Country:
Your Children
List all children, regardless of age, residence, or immigration intent.
First Name: Middle Name: Last (Maiden) Name:
Other Names Used:
Sex:
Birth Date:  ,  City/State of Birth: Country of Birth:
Citizen Of: Immigration Status: Status Expires:  , 
First Name: Middle Name: Last (Maiden) Name:
Other Names Used:
Sex:
Birth Date:  ,  City/State of Birth: Country of Birth:
Citizen Of: Immigration Status: Status Expires:  , 
First Name: Middle Name: Last (Maiden) Name:
Other Names Used:
Sex:
Birth Date:  ,  City/State of Birth: Country of Birth:
Citizen Of: Immigration Status: Status Expires:  , 
First Name: Middle Name: Last (Maiden) Name:
Other Names Used:
Sex:
Birth Date:  ,  City/State of Birth: Country of Birth:
Citizen Of: Immigration Status: Status Expires:  , 
First Name: Middle Name: Last (Maiden) Name:
Other Names Used:
Sex:
Birth Date:  ,  City/State of Birth: Country of Birth:
Citizen Of: Immigration Status: Status Expires:  , 
First Name: Middle Name: Last (Maiden) Name:
Other Names Used:
Sex:
Birth Date:  ,  City/State of Birth: Country of Birth:
Citizen Of: Immigration Status: Status Expires:  , 
Your Father
First Name: Middle Name: Last Name:
Other Names Used:
Birth Date:  ,  City/State of Birth: Country of Birth:
Citizen Of: Immigration Status:
Resides in City: State: Country:
Your Mother
First Name: Middle Name: Last Name:
Other Names Used:
Birth Date:  ,  City/State of Birth: Country of Birth:
Citizen Of: Immigration Status:
Resides in City: State: Country:
Your Spouse’s Father
First Name: Middle Name: Last Name:
Other Names Used:
Birth Date:  ,  City/State of Birth: Country of Birth:
Citizen Of: Immigration Status:
Resides in City: State: Country:
Your Spouse’s Mother
First Name: Middle Name: Last Name:
Other Names Used:
Birth Date:  ,  City/State of Birth: Country of Birth:
Citizen Of: Immigration Status:
Resides in City: State: Country:
Current or Proposed Employer
Employer:
Street Address:
City: State: Zip/Postal Code:
Country:
Job Title: Salary: Date Hired:  
What does company do?
Number of Employees: Gross Revenues:
Prior Employers
Employer:
Street Address:
City: State: Zip/Postal Code:
Country:
Job Title: Date Hired:   Date Left:  
Employer:
Street Address:
City: State: Zip/Postal Code:
Country:
Job Title: Date Hired:   Date Left:  
Employer:
Street Address:
City: State: Zip/Postal Code:
Country:
Job Title: Date Hired:   Date Left:  
Employer:
Street Address:
City: State: Zip/Postal Code:
Country:
Job Title: Date Hired:   Date Left:  
Employer:
Street Address:
City: State: Zip/Postal Code:
Country:
Job Title: Date Hired:   Date Left:  
Education
Degree: Major: Graduation Date:  
College/University:
Street Address:
City: State: Zip/Postal Code:
Country:
Degree: Major: Graduation Date:  
College/University:
Street Address:
City: State: Zip/Postal Code:
Country:
Degree: Major: Graduation Date:  
College/University:
Street Address:
City: State: Zip/Postal Code:
Country:
Immigration History
Current/Last Immigration Status: Status Expires/Expired: ,
Last Entry to the US: Entry Date: ,
Prior Immigration Statuses Held/Petitions and Applications Filed:
B-1/B-2 Visitor:
E Investor/Trader:
F-1 Student:
H-1B/H-3: 		J Exchange Visitor:
L Intra-Company Transfer:
M Student:
O Extraordinary Ability: 		P Athlete/Artist:
Q Cultural Exchange:
R Religious Worker:
Other:
Family Based Petition:
Labor Certification:
Asylum:
Other Petition:
Other Information
If you have ever been arrested, please state when, for what, and the results:
If you have ever claimed to be a United States Citizen, or voted in the US, please state when, for where, and why:
If you have ever denied a visa or entry to the United States, please state when, for where, and why:
Is there any other information you think might have an impact on your immigration case:
 
Eng & Nishimura
1055 W 7th St Ste 1780, Los Angeles, CA 90017
213.622.2255
email