IMMIGRATION LAW GROUP LLP
2880
Zanker Road, Suite 201
San
Jose, CA 95134
Phone:
(408) 432-9200
Fax:
(408) 432-9191
Employment Based AOS
Questionnaire for Minors Under 14 Years
of Age
To download a MS Word version of this
document, right click on
this link and select "Save Target
As" (for mac users, CTRL + click).
Please answer the following questions:
Name:
Male
o
Female
o
First
Middle Last
Home Address:
Street
Address
City
State Zip
Code
Other names used:
Home Phone Number: (
)
Date of Birth:
City,
State/Province and Country of Birth:
________
Social Security Number:
- -
I-94
Number:
Consulate where Visa was issued:
Date of last arrival:
City & State of last entry:
Were you inspected by a U.S. Immigration
Officer?
o
Yes
o
No
Have you ever applied for permanent
residency before?
o
Yes
o
No
If yes, please explain:
______________________________________________________
__________________________________________________________________________
________________________________________________________
If your answer is
“Yes” on any one of these questions,
explain on a separate piece of paper.
Answering “Yes” does not necessarily
mean that you are not entitled to
register for permanent residence or
adjust status.
Have
you ever, in or outside the U.S.:
a.
knowingly
committed any crime of moral turpitude
or a drug-related offense for which you
have not been arrested?
b.
Been arrested, cited charged,
indicted, fined, or imprisoned for
breaking or violating any law or
ordinance, excluding traffic violations?
c.
Been the beneficiary of a pardon,
amnesty,
rehabilitation decree, other act
of clemency or similar action?
d.
Exercised diplomatic immunity to
avoid prosecution for a criminal offense
in the U.S.?
o Yes
o No
Have
you received public assistance in the
U.S. from any source, including the U.S.
government or any state, country, city,
or municipality (other than emergency
medical treatment), or are you likely to
receive public assistance in the future?
o Yes
o No
Have
you ever:
a.
within
the past 10 years been a prostitute or
procured anyone for prostitution, or
intend to engage in such activities in
the future?
b.
Engaged in any unlawful
commercialized vice, including, but not
limited to, illegal gambling?
c.
Knowingly encouraged, induced,
assisted, abetted or aided any alien to
try to enter the U.S. illegally?
d.
Illicitly trafficked in any controlled
substance, or knowingly assisted,
abetted or colluded in the illicit
trafficking of any controlled
substance?
o Yes
o No
Have
you ever engaged in, conspired to engage
in, or do you intend to engage in, or
have you ever solicited membership or
funds for, or have you through any means
ever assisted or provided any type of
material support to, any person or
organization that has been engaged or
conspired to engage, in sabotage,
kidnapping, political assassination,
hijacking, or any other form of
terrorist activity?
o Yes
o No
Do you
intend to engage in the U.S.
in:
a.
espionage?
b.
Any activity a purpose of which
is opposition to, or the control or
overthrow of, the Government of the
United States, by force, violence or
other unlawful means?
c.
Any
activity to violate or evade any law
prohibiting the export from the United
States of goods, technology or sensitive
information?
o Yes
o No
Have
you ever been a member of, or in any way
affiliated with, the Communist Party or
any other totalitarian party?
o Yes
o No
Did
you, during the period March 23, 1933 to
May 8, 1945, in association with either
the Nazi Government of Germany or any
organization or government associated or
allied with the Nazi Government of
Germany, ever order, incite, assist or
otherwise participate in the persecution
of any person because of race, religion,
national origin or political opinion?
o Yes
o No
Have
you ever engaged in genocide, or
otherwise ordered, incited, assisted or
otherwise participated in the killing of
any person because of race, religion,
nationality, ethnic origin, or political
opinion?
o Yes
o No
Have
you ever been deported from the U.S., or
removed from the U.S. at government
expense, excluded within the past year,
or are now in exclusion or deportation
proceedings?
o Yes
o No
Are
you under a final order of civil penalty
for violating section 274C of the
Immigration Act for use of fraudulent
documents, or have you, by fraud or
willful misrepresentation of a material
fact, ever sought to procure, or
procured, a visa, other documentation,
entry into the U.S., or any other
immigration benefit?
o Yes
o No
Have
you ever left the U.S. to avoid being
drafted into the U.S. Armed Forces?
o Yes
o No
Have
you ever been a J nonimmigrant exchange
visitor who was subject to the 2 year
foreign residence requirement and not
yet complied with that requirement or
obtained a waiver?
o Yes
o No
Are
you now withholding custody of a U.S.
Citizen child
outside the U.S. from a person granted
custody of the child?
o Yes
o No
Do you
plan to practice polygamy in the
U.S.?
o Yes
o No
